The Outcome of Primary Architectural Distortion in Mammography: Which are the Important Factors?

Architectural distortion is an important mammographic finding for non-palpable breast cancer, which is a difficult part of mammographic reporting. In this study, we assessed the relationship between architectural distortion without mass or history of previous breast intervention with pathological findings, as well as the risk of malignancy associated with architectural distortion. The factors that might increase the chance of malignancy in architectural distortion were also evaluated. In this descriptive, comparative cross sectional survey, 30 consecutive patients with mammographic primary architectural distortion were enrolled. The pathological findings were determined through core needle biopsy and compared across the other variables. The pathological results were fibrocystic changes, carcinoma in situ, invasive ductal carcinoma, other benign pathology, and high-risk lesion of adenosis sclerosing with 5 (16.7%), 5 (16.7%), 13 (43.3%), 6 (20%), and 1 (3.3%) patients, respectively. Higher BI-RADS category (P = 0.064), accompanying mammographic lesion (P = 0.004), positive clinical symptoms (P = 0.040), and positive ultrasonography finding (P = 0.013) were related to greater chance of malignant pathology result. Based on our findings, it can be concluded that architectural distortion in imaging is accompanied by malignancy in 60% of the cases and there are some important factors that can increase the risk of malignancy for architectural distortion (AD).