Clinical implications of architectural distortion visualized by breast ultrasonography

Recently, Architectural distortion (AD) has been detected via ultrasonography (US) even in the absence of a definitive mass; however, the clinical significance of this finding is yet unknown. The purpose of this study is to elucidate the causes of AD, as revealed by US.

Breast echo was undergone by 931 patients between January and December 2005. The study comprised 45 patients (4.8%) in the age range of 28-76 years (mean 49.8 years) whose images revealed AD despite the absence of mass formation. To investigate the causes of this AD, we retrospectively reviewed the medical records of these patients.

In 10 of 45 cases in which US revealed AD, the distortion was attributed to the biopsy procedures. Of these ten patients, seven underwent Mammotome biopsy, two underwent open biopsy; one underwent core-needle biopsy. Seven patients had previous histories of neoadjuvant chemotherapy for breast cancer. Fifteen lesions were benign, and 13 lesions were malignant disease pathologically.

Emphasis on the increasing value of AD detection by US and professional awareness of this fact are of tremendous importance.