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Architectural Distortion on Mammography: Correlation With Pathologic Outcomes and Predictors of Malignancy.

Publication ,  Journal Article
Bahl, M; Baker, JA; Kinsey, EN; Ghate, SV
Published in: AJR Am J Roentgenol
December 2015

OBJECTIVE: The objective of our study was to determine the risk of malignancy associated with architectural distortion and to evaluate the imaging and clinical features that may contribute to the prediction of malignancy in the setting of architectural distortion. MATERIALS AND METHODS: We performed a retrospective review of architectural distortion cases from January 1, 2004, to December 31, 2013. Imaging findings and pathology outcomes were reviewed. RESULTS: Over the 10-year study period, architectural distortion that was considered to be suspicious for or highly suggestive of malignancy was present in 435 of 231,051 (0.2%) mammographic examinations. Cases were excluded if the main finding described was a mass with an associated feature of architectural distortion (n = 62) or if no pathology results were available (n = 4). Two hundred seventy-five cases of invasive adenocarcinoma or ductal carcinoma in situ (DCIS) were identified; the positive predictive value (PPV) was therefore 74.5% (275/369). DCIS alone was identified in only 4.1% (15/369). The most common benign finding on pathology was a radial scar or complex sclerosing lesion (27/369, 7.3%). Architectural distortion was less likely to represent malignancy on screening mammography than on diagnostic mammography (67.0% vs 83.1%, respectively; p < 0.001). Architectural distortion without a sonographic correlate was less likely to represent malignancy than architectural distortion with a correlate (27.9% vs 82.9%, respectively; p < 0.001). There was no statistically significant difference in the malignancy rate between pure architectural distortion and architectural distortion with calcifications or asymmetries (73.0% vs 78.8%; p = 0.26). CONCLUSION: The PPV of architectural distortion for malignancy is 74.5%. Architectural distortion is less likely to represent malignancy if detected on screening mammography than on diagnostic mammography or if there is no sonographic correlate.

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Published In

AJR Am J Roentgenol

DOI

EISSN

1546-3141

Publication Date

December 2015

Volume

205

Issue

6

Start / End Page

1339 / 1345

Location

United States

Related Subject Headings

  • Risk Assessment
  • Retrospective Studies
  • Predictive Value of Tests
  • Nuclear Medicine & Medical Imaging
  • Middle Aged
  • Mammography
  • Humans
  • Female
  • Breast Neoplasms
  • Aged, 80 and over
 

Citation

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MLA
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Bahl, M., Baker, J. A., Kinsey, E. N., & Ghate, S. V. (2015). Architectural Distortion on Mammography: Correlation With Pathologic Outcomes and Predictors of Malignancy. AJR Am J Roentgenol, 205(6), 1339–1345. https://doi.org/10.2214/AJR.15.14628
Bahl, Manisha, Jay A. Baker, Emily N. Kinsey, and Sujata V. Ghate. “Architectural Distortion on Mammography: Correlation With Pathologic Outcomes and Predictors of Malignancy.AJR Am J Roentgenol 205, no. 6 (December 2015): 1339–45. https://doi.org/10.2214/AJR.15.14628.
Bahl M, Baker JA, Kinsey EN, Ghate SV. Architectural Distortion on Mammography: Correlation With Pathologic Outcomes and Predictors of Malignancy. AJR Am J Roentgenol. 2015 Dec;205(6):1339–45.
Bahl, Manisha, et al. “Architectural Distortion on Mammography: Correlation With Pathologic Outcomes and Predictors of Malignancy.AJR Am J Roentgenol, vol. 205, no. 6, Dec. 2015, pp. 1339–45. Pubmed, doi:10.2214/AJR.15.14628.
Bahl M, Baker JA, Kinsey EN, Ghate SV. Architectural Distortion on Mammography: Correlation With Pathologic Outcomes and Predictors of Malignancy. AJR Am J Roentgenol. 2015 Dec;205(6):1339–1345.

Published In

AJR Am J Roentgenol

DOI

EISSN

1546-3141

Publication Date

December 2015

Volume

205

Issue

6

Start / End Page

1339 / 1345

Location

United States

Related Subject Headings

  • Risk Assessment
  • Retrospective Studies
  • Predictive Value of Tests
  • Nuclear Medicine & Medical Imaging
  • Middle Aged
  • Mammography
  • Humans
  • Female
  • Breast Neoplasms
  • Aged, 80 and over