Malignant Outcomes of Architectural Distortion on Tomosynthesis: A Systematic Review and Meta-Analysis

Abstract

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Digital tomosynthesis spot view in architectural distortions: outcomes in management and radiation dose

“…In our study, architectural distortion without a US/MRI correlate was less likely to represent malignancy than AD with a correlate (p < 0.05); sonographic [15][16][17][18][19][20][21] and MRI [22] correlation also emerged in the literature. All ADs require an ultrasound check; in fact AD at DBT is less likely to represent malignancy without correlative findings on US [21]; nonetheless, it is still a prerequisite to undergoing biopsy, given that the risk of malignancy is nearly 30% [21,23].…”

Pathological outcome of sonographically occult architectural distortions (AD) visible only on digital breast tomosynthesis, and comparison with AD visible also on 2D mammography

“…In addition, AD without correlative findings on ultrasound are less likely to represent malignancy [7,8,13]. Several studies [7][8][9][10][11]14] have reported that AD detected exclusively at DBT (with or without ultrasound correlate) are associated with significant risk of malignancy -ranging Abbreviations: AD, Architectural distortion; DBT, Digital breast tomosynthesis; 2D, mammography; DBT-VAB, Digital breast tomosynthesis-vacuum assisted biopsy. from 10.2% [10] to 50.7% [7].…”

Management of Architectural Distortion on Digital Breast Tomosynthesis With Nonmalignant Pathology at Biopsy

“…These results suggest that imaging surveillance rather than surgery can be considered for architectural distortion on DBT yielding radial scar and other benign pathologies without atypia at biopsy. Given the high malignancy rate of architectural distortion on DBT, core needle biopsy continues to be recommended even when a sonographic correlate is absent [10][11][12]. However,…”

“…While DBT-detected architectural distortion is less likely to be a manifestation of cancer than is DM-detected distortion, the associated malignancy risk is sufficiently high that routine biopsy is required for histological analysis [10][11][12]. Surgical excision has long been advocated for the management of DM-detected architectural distortion; however, more recent evidence suggests that surgical excision of DM-…”