Figure 7d. Images in a 59-year-old woman with invasive ductal carcinoma of the right breast. (a) Mediolateral oblique mammogram of the right breast shows subtle architectural distortion (arrow) in the superior aspect of the breast. (b) Radiograph of lumpectomy tissue demonstrates distortion that represents carcinoma surrounding barb of localization wire and biopsy marking clip. (c) Right mediolateral oblique CAD image demonstrates unacceptable segmentation (arrowheads) and biopsy-proved cancer missed by the CAD system. (d) Repeated right mediolateral oblique CAD image demonstrates acceptable segmentation. Site of malignancy is correctly identified by the CAD system, as indicated (*).