What it means
Breast tissue normally has soft lines that run smoothly toward the nipple. In architectural distortion, some of those lines are drawn together toward a point, or the edge of the tissue looks pulled or puckered, but no lump is seen. 3D mammography (tomosynthesis) shows it more often than standard 2D images. Causes include scars from surgery or biopsy, a benign change called a radial scar, and sometimes cancer.
When it matters
If the distortion sits where you had surgery or a biopsy and matches the scar, it is usually considered benign. Otherwise it is taken seriously, because it can be an early sign of breast cancer, even though many cases turn out benign. Next steps usually include extra mammogram views and an ultrasound. If the area stays unexplained, a biopsy is usually advised, even when the ultrasound looks normal.
Questions to ask your doctor
- Could this distortion come from an earlier surgery or biopsy scar?
- Was anything seen on ultrasound in the same spot?
- If a biopsy is advised, how will it be guided?
