Table 4 Architectural distortion—-review of literature.

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

Name (year)

Lesions (number)

Exclusionsa

CNBs with cancer (%)b

Cancers that are IC (%)

ILC (%)c

Additional data for ICd

SCL w/o atypia(%)

Cancer upgrade (%)

Other benign findings (%)

Cancer upgrade (%)

ADH (%)

Cancer upgrade (%)

ALH/LCIS (%)

Cancer upgrade (%)

Venkatesan 12 (2009)

373

M, ca + +

27%

99%

NP

NP

NP

NP

NP

NP

NP

NP

NP

NP

Bahl13 (2015)e

369

M, post surg

75%

96%

25%f

NP

12%

NPe

13%

NPe

1%

NPe

0

NA

Bahl8 (2017)

395

M

58%

92%

34%

NP

30%

NP

10%

NP

2%

NP

NP

NP

Vijapura14 (2018)

84

None

69%

95%

25%

NP

19%

9%g

7%

NP

NP

NP

NP

NP

Alshafeiy9 (2018)h

172

M, post surg

30%

90%

27%

NP

9%

0%

57%

13%

5%

50%

0%

NA

Pujara15 (2019)

74

M, ca + +, asymm, post surg

35%

85%

41%

NP

34%

0%

26%

0%

3%

0%

5%

0%

Walcott-Sapp16 (2019)

116

M, ca + +, US

20%

91%

20%

Size, LNi

22%

0%

51%

0%

4%

0%

3%

50%

Ambinder17 (2020)j

151

US

18%

78%

62%

NP

23%

0%

48%

0%

5%

33%

7%

NP

Rochart6 (2020)

148

M, US

14%

67%

NP

NP

36%

0%

39%

21%

≥1%k

50%

≥2% k

34%

Bachert (2021)

588 (total cases)

None

31%

89%

32%

Size, LN, grade, ER, PR, HER2, Stage

24%

1%

33%

8%

4%

33%

6%

32%

365 (multi-feature)

None

39%

89%

34%

Size, LN, grade, ER, PR, HER2, Stage

19%

1%

42%

16%

4%

50%

5%

18%

223 (single feature)

M, ca + +, US, MRI

18%

90%

29%

Size, LN, grade, ER, PR, HER2, Stage

31%

0%

51%

0%

10%

16%

7%

33%

Summary of Results

2470

 

40%

92%

34%

 

22%

1% (2 of 149))L

28%

10% (14 of 139)m

2%

37% (15 of 41)n

2%

31% (9 of 29)o

  1. ADH atypical ductal hyperplasia, ALH atypical lobular hyperplasia, CNB core needle biopsy, IC invasive carcinoma, IDC invasive ductal carcinoma, ILC invasive lobular carcinoma, LCIS lobular carcinoma in situ, NP not provided, SCL sclerosing lesion (includes radial sclerosing lesion (RSL or radial scar), sclerosing adenosis, complex sclerosing lesion (CSL)), w/o without.
  2. aSome studies excluded cases if there was an additional image finding on mammography of a mass (M), calcifications (ca + +), or asymmetry (asymm), or if there was a correlate on ultrasound (US), or if the AD was associated with post surgical changes (post surg). For the current study, single feature AD was defined as cases that were not associated with a mass, calcifications, or a correlate on US or MRI.
  3. bAll malignancies were either invasive carcinoma or DCIS.
  4. cThis is the percent of invasive carcinomas that were invasive lobular carcinoma.
  5. dThe majority of the studies reported the histologic types of invasive carcinomas and cases of DCIS. Only one other study reported additional pathologic information about carcinomas16. The average size of the invasive carcinomas was 0.8 cm (range 0.4–1.9 cm) and two of 20 carcinomas were associated with positive lymph nodes.
  6. eThe pathologic results for this study are given for the final results of excision with or without prior core needle biopsy. 265 (96%) of the cancers were detected on CNB and an additional 10 on excisions after benign findings in the CNB (1 invasive carcinoma and 7 cases of DCIS). Therefore, 10 of 104 CNBs (10%) were upgraded. It is not specified how many of the lesions were sclerosing lesions and how many were other benign lesions.
  7. fIn this paper, the histologic types of the cancers were given as “ILC with or without ductal features,” “invasive adenocarcinoma with mixed ductal and lobular features,” and “invasive ductal adenocarcinoma with or without lobular features”.
  8. gEleven RSLs were excised and one was upgraded to DCIS. The 4 cases of sclerosing adenosis may not have undergone excision.
  9. hNine of the lesions were evaluated by excision (type of lesion not provided). None showed malignancy. These cases are not included in the totals. The types of cancers (IDC (including tubular), ILC, mixed, and DCIS include 4 cancers that were detected on excision but the type was not specified.
  10. iInformation about the size of the invasive carcinomas was provided (average 0.8 cm, range 0.4–1.9) as well as lymph node status (2 of 20 carcinomas were associated with positive nodes).
  11. jThere were 50 high-risk lesions defined as RSL/CSL (31 cases), ADH (8 cases), ALH/LCIS (10 cases), and papilloma (1 case). 6 cases of ADH were excised and 2 showed cancer. 25 additional high-risk lesions were excised and did not show cancer. The specific lesions excised were not provided. Two of the 6 cases of DCIS were upgraded to invasive carcinoma on excision.
  12. k“High risk lesions” were listed as a group but the absolute numbers of cases of ADH and ALH/LCIS were not given.
  13. lOf 149 sclerosing lesions without atypia that underwent excision, only 2 revealed malignancy. Both malignancies were DCIS.
  14. mOf 139 CNBs showing benign findings other than sclerosing lesions that underwent excision, 14 were upgraded to cancer. Nine were invasive carcinoma, 1 DCIS, and 4 were not specified as to type.
  15. nOf 41 CNBs showing ADH that underwent excision, 15 were upgraded to cancer. Six were invasive ductal carcinoma, one tubular carcinoma, and 8 DCIS.
  16. oOf 29 CNBs showing ALH or LCIS that underwent excision, 9 were upgraded to cancer. Three were invasive ductal carcinoma, two were invasive lobular carcinoma, one was invasive carcinoma with ductal and lobular features, and 3 were DCIS.
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