This case takes place in North Dakota and involves a delayed diagnosis in breast cancer. The patient, a female in her mid-sixties, had a mammogram with suspicious findings, so it was recommended that she undergo further workup for possible malignancy. However, the patient was not notified of these findings, and no further workup was done. Fourteen months went by after the initial imaging was done before the patient received appropriate follow-up. The patient underwent a second mammogram which revealed that she had an aggressive tumor. The initial mammogram had revealed tumor of 1 cm or less in size. Fourteen months later, there appeared to be three tumors one of which was over 3 cm.