Journal of Korean Society of Ultrasound in Medicine 2008;27(4): 189-195.
Sonographically Detected Architectural Distortion: linical Significance.
Shin Kee Kim, Bo Kyoung Seo, Ann Yi, Sang Hoon Cha, Baek Hyun Kim, Kyu Ran Cho, Young Sik Kim, Gil Soo Son, Young Soo Kim, Hee Young Kim
1Department of Radiology, Korea University Ansan Hospital, Ansan, Korea. seoboky@korea.ac.kr
2Department of Radiology, Korea University Anam Hospital, Seoul, Korea.
3Department of Pathology, Korea University Ansan Hospital, Ansan, Korea.
4Department of General Surgery, Korea University Ansan Hospital, Ansan, Korea.
5Department of Biostatistics, Korea University, Seoul, Korea.
  Published online: December 1, 2008.
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.
Keywords: Breast; Breast neoplasms; Ultrasonography; Mammography
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