J Korean Soc Ultrasound Med.  2008 Dec;27(4):189-195.

Sonographically Detected Architectural Distortion: linical Significance

• Kim SK
• Seo BK
• Yi A
• Cha SH
• Kim BH
• Cho KR
• Kim YS
• Son GS
• Kim YS
• Kim HY

Abstract

PURPOSE: Architectural distortion is a suspicious abnormality for the diagnosis of breast cancer. The aim of this study was to investigate the clinical significance of sonographically detected architectural distortion.
MATERIALS AND METHODS
From January 2006 to June 2008, 20 patients were identified who had sonographically detected architectural distortions without a history of trauma or surgery and abnormal mammographic findings related to an architectural distortion. All of the lesions were pathologically verified. We evaluated the clinical and pathological findings and then assessed the clinical significance of the sonographically detected architectural distortions.
RESULTS
Based on the clinical findings, one (5%) of the 20 patients had a palpable lump and the remaining 19 patients had no symptoms. No patient had a family history of breast cancer. Based on the pathological findings, three (15%) patients had malignancies. The malignant lesions included invasive ductal carcinomas (n = 2) and ductal carcinoma in situ (n = 1). Four (20%) patients had high-risk lesions; atypical ductal hyperplasia (n = 3) and lobular carcinoma in situ (n = 1). The remaining 13 (65%) patients had benign lesions, however, seven (35%) out of 13 patients had mild-risk lesions (three intraductal papillomas, three moderate or florid epithelial hyperplasia and one sclerosing adenosis).
CONCLUSION
Of the sonographically detected architectural distortions, 35% were breast cancers or high-risk lesions and 35% were mild-risk lesions. Thus, a biopsy might be needed for an architectural distortion without an associated mass as depicted on breast ultrasound, even though the mammographic findings are normal.

Keyword

Breast; Breast neoplasms; Ultrasonography; Mammography

MeSH Terms

Biopsy
Breast
Breast Neoplasms
Carcinoma, Ductal
Carcinoma, Intraductal, Noninfiltrating
Carcinoma, Lobular
Humans
Hyperplasia
Mammography
Papilloma, Intraductal