Table 1 Pathologic correlates of lesions associated with mammographic architectural distortion (AD).

From: Breast lesions associated with mammographic architectural distortion: a study of 588 core needle biopsies

Pathologic lesion

No. of cases (%)

No. excised

No. with DCIS on excision

No. with invasive carcinoma on excision

Total no. (%) upgraded to carcinoma on excision

All cases (n = 588)

Malignant lesions

184 (31%)

    

    Invasive carcinoma

164

155a

2

152b

N/A

    DCIS

20

20c

16

3

N/A

Benign lesions very likely to correlate with AD

218 (37%)

    

    Without atypia

172

94

1

0

1 (1%)

    With atypiad

27

25

5

2

7 (28%)

    With ALH/LCISe

19

10

1

1

2 (20%)

Benign lesions that may or may not correlate with AD

186 (32%)

    

    Without atypia

160

68

0

6

6 (9%)

    With atypiad

12

10

2

2

4 (40%)

    With ALH/LCISe

14

9

2

2

4 (44%)

Total for benign lesions

404

216 (53%)

11

13

24 (11%)

Single-feature AD (n = 223)

Malignant lesions

40 (18%)

    

    Invasive carcinoma

36

34a

0

33b

N/A

    DCIS

4

4

4

0

N/A

Benign lesions very likely to correlate with AD

101 (45%)

    

    Without atypia

77

37

0

0

0 (0%)

    With atypiad

14

12

1

1

2 (17%)

    With ALH/LCISe

10

5

1

0

1 (20%)

Benign lesions that may or may not correlate with AD

82 (37%)

    

    Without atypia

67

30

0

0

0 (0%)

    With atypiad

9

7

1

0

1 (14%)

    With ALH/LCISe

6

4

1

1

2 (50%)

Total for benign lesions

183

95 (52%)

4

2

6 (6%)

Multi-feature AD (n = 365)

Malignant lesions

144 (39%)

    

    Invasive carcinoma

128

121a

2

119b

N/A

    DCIS

16

16c

12

3

N/A

Benign lesions very likely to correlate with AD

117 (32%)

    

    Without atypia

95

57

1

0

1 (1%)

    With atypiad

13

13

4

1

5 (38%)

    With ALH/LCISe

9

5

0

1

1 (11%)

Benign lesions that may or may not correlate with AD

104 (28%)

    

    Without atypia

93

38

0

6

6 (16%)

    With atypiad

3

3

1

2

3 (100%)

    With ALH/LCISe

8

5

1

1

2 (40%)

Total for benign lesions

221

121 (55%)

7

11

18 (15%)

  1. aThree patients had distant metastases at presentation and did not undergo excision (all with multi-feature AD). Six patients did not have follow-up information (4 with multi-feature AD and 2 with single feature AD).
  2. bIn two cases, a small invasive carcinoma was completely removed by the core needle biopsy. One had residual DCIS (multi-feature AD) and one did not (single feature AD). In the third case, the patient underwent neoadjuvant chemotherapy and only residual DCIS was present (multi-feature AD)
  3. cThe pathologic results for one patient who underwent excision for DCIS were not available (multi-feature AD).
  4. d“Atypia” included cases in which excision was recommended due to the presence of ADH, FEA, architectural or nuclear atypia, or in situ lobular lesions that were not classified as a classic in type (additional details are provided in Table 3).
  5. eThis group includes lesions with ALH or LCIS of classic subtype. The BWH institutional guideline is that excision is not recommended solely due to the presence of these incidental lesions. In these cases, excision would have been recommended based on other features.
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