This case involves a forty-five-year-old female who presented to her primary care physician’s office with complaints of a nodular lump on her breast. At the initial visit, the patient was only seen by a medical student, the physician did not interview or examine the patient. The student reported the lump as a small fixed mass that appeared to have some dimpling of the surrounding tissue. The patient was scheduled and sent for a mammogram. The test was reported as having no abnormalities other than fibrocystic breast disease. Six months later the lump grew to 5cm x 5cm and, at this point, an additional mammogram follow-up was ordered. Further imaging studies reported that the patient now had a severe metastatic disease.