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A mimic of breast carcinoma 1-year post vacuum-assisted excision of a benign breast lesion. A 64-year-old woman underwent vacuum-assisted excision (VAE) for a biopsy-proven radial scar in the right breast detected during screening mammography. A follow-up mammogram was performed at 1 year following multidisciplinary team discussion. This demonstrated a 1 cm mass adjacent to the biopsy clip at the site of the prior VAE. A repeat biopsy of the mass was performed which revealed benign scar tissue. This is the first reported case of post-VAE scar tissue mimicking breast carcinoma on mammography.