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Architectural distortion

sfrields
sfrields Member Posts: 7
edited January 2021 in Waiting for Test Results

Hi! I’m 39 and had my screening mammogram done about 6 months ago. I was called back for a diagnostic of my right breast and an ultrasound of my left. The left was just lumpy as both breasts are very dense. The distortion that was seen on my right breast was not there in the diagnostic one so the radiologist told me she debated telling me to come back in a year but just to be on the same side come back in 6 months.

My 6 month diagnostic mammogram on the right side was last week and I immediately got an ultrasound because the distortion was back. She said it was only on one view and it didn’t show up on the ultrasound which was very encouraging but she wanted to biopsy it anyway. I had the biopsy done Friday and will hear back Tuesday or Wednesday. I’m really really scared and just looking for support. Also I was kind of confused because she also told me very few distortion cases need nothing further. She said either way (benign or malignant) I will need surgery to remove the area because it can turn into cancer.

Comments

  • kathabus
    kathabus Member Posts: 45

    Hi--Well, I'm glad you'll definitely know what this area is now. No more guessing. The "not knowing" is the part of this that can drive us the most crazy.

    Since the radiologist did a 6 month check, it didn't sound like she/he was TOO concerned the first time? Did they happen to give you a BI-RADS score? That sort of tells us how suspicious the finding is. For example, a BI-RADS 3 would be "probably benign."

    Mammograms pick up things differently than ultrasounds....so just because it's on one and not another doesn't lean a diagnosis one way or another. That's exactly why they use both. I had a papilloma, a benign finding...and it was only seen on the mammogram because my nipple was creating a shadow on the ultrasound. Just an example of why you would see something on one and not the other.

    All I can say is....try to distract yourself as best as you can until you get your results. Put on a feel good xmas movie! I know it's hard. We've all been there. Fingers crossed it's nothing. Please keep us posted!


  • Odd. If you don't have the biopsy results yet, how can the doctor say "either way (benign or malignant) I will need surgery to remove the area because it can turn into cancer."?

    While architectural distortion can be a sign of the presence of breast cancer, architectural distortion can be caused by other conditions that are totally benign and will never develop into cancer.

    From Radiopedia: https://radiopaedia.org/articles/breast-architectural-distortion-1

    "Breast architectural distortion is a descriptive term in breast imaging (mammography, ultrasound, and MRI) to indicate that the breast parenchyma is tethered or indented. The finding per se is not a mass."

    "Many entities can cause architectural distortion. In practice, the most common are surgery and malignancy. It is considered the third most common appearance of breast cancer.

    • primary causes
      • invasive breast cancer, including both invasive lobular carcinoma and invasive ductal carcinoma
      • ductal carcinoma in situ
      • radial scar/complex sclerosing lesion
      • fat necrosis
      • sclerosing adenosis
      • fibromatosis
    • secondary causes
      • postsurgical scars (most common)
      • trauma
      • infection "


    On the above list, everything is benign except for the first two items (invasive breast cancer and DCIS). I believe that usually a needle biopsy diagnosis of a radial scar will lead to an excisional (surgical) biopsy, to confirm the diagnosis and ensure that nothing more serious is lurking. I could be wrong but I don't think that any of the other findings would usually lead to surgery.

    So I'd say wait for the result and then see what happens.

    Good luck! Let us know when you get the result. Hopefully it's something that is completely benign and doesn't need any further action, fat necrosis, for example (I had that on a biopsy once).

  • sfrields
    sfrields Member Posts: 7

    Thank you for your reply. I didn’t get a BIRAD score. The encouraging thing she said was that it’s unlikely to be cancer because it was only on one view and there was nothing on the ultrasound. She said in her experience that usually means no cancer.

    The original screening showed it and I immediately had a diagnostic done the next week and it wasn’t there. That radiologist told me to come back in 6 months just to be sure since it wasn’t there on the diagnostic. She said it was probably due to positioning during the mammogram of my dense breasts. When I went back for my 6 month repeat is when they found it again.

    I am pretty confused about the needing surgery either way as well. I’ll just have to wait until I hear back and get the pathology report.

  • LivinLife
    LivinLife Member Posts: 301

    Just want to send support your way! You'll be hearing about results very soon now.... Please let us know of the results, ok?

  • sfrields
    sfrields Member Posts: 7

    Thank you! I did get good news today the pathology came back as normal breast tissue! Woo hoo!! I actually cried in the Sams check out lane when I got the call!

    The radiologist who has been following me is calling Wednesday to discuss further treatment. During the biopsy she talked a lot about surgical interventions even with a benign result so I’m curious to hear what she has to say. I’ll update what I hear from her! I’m really thankful for a place like this that offers support and ebcouragement

  • sfrields, that's great news!

    Be sure to get a copy of the pathology report - having that information will be important in helping you understand whatever the next steps might be. Hopefully all that is recommended is a 6-month screening follow-up, which is pretty common after benign biopsy results.

  • sfrields
    sfrields Member Posts: 7

    I will! Thank you

  • LivinLife
    LivinLife Member Posts: 301

    Great on results! Yes, please let us know how the discussion with the radiologist goes - recommendations..... So happy for you!

  • kathabus
    kathabus Member Posts: 45

    Glad to hear!!


  • sfrields
    sfrields Member Posts: 7

    Hey! So I heard back from the radiologist and she said it is not normal breast tissue but called stromal fibrosis that CAN mimic distortion. She spoke with the pathologist because if there’s only a little fibrosis it’s not concordance but if there’s a lot it would be considered a concordance finding. He said there was a ton so she labeled it concordant. She said I could opt to have it removed so it doesn’t keep showing up in future mammograms or just follow it. I’m a recovery room nurse so I always hear horror stories and decided to have it removed. That happened today. The surgeon told me I would have to wait for the pathology results because to him it looks like “young” fatty tissue. I’m disappointed because i have a coworker who just had a lumpectomy with him for fibroadenoma and he told her right after surgery he was pretty sure it was benign. So of course I’m now worried. Is it easier to tell right after surgery if a fibrooadenoma is benign compared to mine that was just a glob of tissue? He’s a very honest doctor who I have heard tell people it’s cancer before the pathology. Ugh, I just feel like I’m at the beginning again with the worry. He did tell me several times in the office and before surgery cancer is unlikely given the amount of biopsy samples my radiologist took. I just wanted to hear him say nope doesn’t look like cancer. Any words of advice or hopeful experiences

  • melissadallas
    melissadallas Member Posts: 929

    sfrieds, if it is any consolation, they are wrong sometimes about it looking benign when they removed it and sometimes there are surprises hanging out with those fibroadenomas. You never really know until you get it under the microscope. That said, it sounds like they are pretty confident you just have benign fibrosis.

  • sfrields
    sfrields Member Posts: 7

    Thank you for the reassurance. All this back and forth has been going on since early December so I just want to know.
    In your experience can the surgeon look at a fibroadenoma after excision (like my coworker) and tell if it’s more than likely benign. I just want to understand the difference and why he couldn’t tell me anytbing

  • melissadallas
    melissadallas Member Posts: 929

    A fibroadenoma would probably look like a discrete extra dense knot of tissue. Your fibrosis is probably not identifiable or visable to the naked eye and probably looks more or less like any other chunk of fatty/glandular breast tissue

  • sfrields
    sfrields Member Posts: 7

    That makes sense. Thank you