1Both authors: Department of Radiology, Cooper Hospital/University Medical Center, One Cooper Plaza, Camden, NJ 08103. Address correspondence to B. D. Munson-Bernardi. Case Report 58-year-old African American woman with a history of insulindependent diabetes, hypertension, and hyperlipidemia presented for a routine mammogram. The patient reported no palpable abnormality, nipple discharge, or breast tenderness. The patient had a stereotactic biopsy of the left breast in 1999 for indeterminate microcalcifications. The pathology yielded severe atypical ductal hyperplasia and papillomatosis with the surrounding breast tissue heavily involved with amyloid and amyloid microcalcifications. Subsequent excisional biopsy revealed two foci of ductal carcinoma in situ (DCIS), solid and cribriform type of low nuclear grade, fibrocystic change, and florid ductal hyperplasia with microcalcifications as well as microcalcifications consistent with amyloid. One surgical margin was positive for DCIS for which repeat excisional biopsy was required. On reexcision, four specimens were obtained that showed no residual tumor. In 2001, routine craniocaudal and mediolateral oblique (MLO) views of both breasts were performed. The MLO view of the left breast (Fig. 1A) revealed new, rounded, loosely clustered microcalcifications in the upper outer quadrant of the left breast that did not possess the anticipated morphologic characteristics of amyloid calcifications. At the same time, the right breast MLO view (Fig. 1B) showed interval development of a cluster of round microcalcifications in the upper central region that were thought to be indeterminate in morphology and again not clearly indicative of amyloid calcification. Stereotactic core biopsies of both the left and right breasts were performed. Pathology reported benign breast tissue with scattered associated microcalcifications that had characteristic yellow–green birefringence under polarized light. No malignancy was evident. Although not clearly an interval change, in 2003, at the time of a screening mammography, biopsy for the right breast retroareolar microcalcifications was advised because of the segmental distribution, varying size, and fine branching appearance (Fig 1B). The surgeon elected to perform a needle localization biopsy, which yielded atypical ductal hyperplasia and foci of fat necrosis with foveated microcalcifications associated with amyloid deposition. No malignancy was found.