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Updated: Jan 29, 2026

Detection of Architectural Distortion in Prior Mammograms via Analysis of Oriented Patterns
Published on: August 30, 2013
Pathology results of architectural distortion on detected with digital breast tomosynthesis without definite
Sarah Walcott-Sapp1, Jennifer Garreau2, Nathalie Johnson2
1Department of Surgery, Oregon Health and Science University, 3181 S.W. Sam Jackson Park Rd. Mail Code: L223, Portland, OR, 97239, USA.
Background:
Digital breast tomosynthesis (DBT) is a mammographic technique which improves the detection of breast cancer. Architectural distortion of malignancy may be occult on 2D mammography and ultrasound but detected by DBT.
Methods:
110 patients who underwent 116 DBT-guided needle biopsies for architectural distortion were identified between June 2014 and August 2017 and underwent review of medical records.
Results:
59 of 116 biopsies (51%) revealed lesions warranting further consideration or excision. These included 21 specimens with invasive carcinoma, 2 ductal carcinoma in situ (DCIS), 5 atypical ductal hyperplasia, 4 atypical lobular hyperplasia, and 2 other lesions. 46 lesions were excised. Surgical pathology demonstrated 22 malignant lesions (20 invasive carcinomas and 2 DCIS). 11 patients continued surveillance and two patients were lost to follow up. 94 lesions (87%) were not visible on ultrasonography.
Conclusions:
DBT-guided biopsy for architectural distortion detected a malignancy in 19% of lesions, demonstrating the importance of pathologic diagnosis for lesions without correlating ultrasound findings.
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