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Topic: Architectural distortion found on mamo

Forum: Benign Breast Conditions —

A safe place to worry for members who have not been diagnosed with breast cancer, but have concerns about their breasts.

Posted on: Sep 15, 2020 05:40AM - edited Sep 15, 2020 05:43AM by Bellamom

Bellamom wrote:

got the dreaded call back from the office for mamo that was done 3 weeks prior. At time doctor performed ultrasound and mamo and I had exam and nothing was of concern. Shocked when I got the call to come in for more pix. The radiologist said architectural,distortion on right breast. Spot magnification needed. I went yesterday and had it done on my breast. Then had an exam and saw the breast doc again. He didn't seem concerned and suggested I come back in six months for mamo. He is also sending it out again to radiologist for his opinion. Will know in one week. I'm scared to death..I didn't know when I was there that architectural,distortion is not a good thing. He didn't seem concerned so when he said he's sending back to radiologist but thinks 6 month mamo is in order I was happy. Now I've spent the entire time since getting home yesterday researching this and I am sick to to my stocmache. My mom had breast cancer and I ,ost her when she was 48. I've been tested for BRCA genes and was negative. I'm so at a loss here. I k ow what breast cancer does and watched y mom as a young girl suffer and deteriorate. I'm beyond upset at this point. Any insight as to this condition?

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Sep 15, 2020 08:00AM Moderators wrote:

Bellamom, we completely understand your fears, and we're sorry you are here, but wanted to say that we're glad that you found us! Many women here have gone through what you're going right now and we're sure some will jump in here soon to share personal experiences and support. Good luck with everything, and please come back to let us know how you're doing!

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Sep 15, 2020 09:21AM Beesie wrote:

Bellamom, with your family history, I can understand why you are scared. And yes, architectural distortion can be a sign of breast cancer. But most often, it's not.

Architectural distortion found on a mammogram

"Breast cancer commonly causes architectural distortion.

Architectural distortion uncommonly indicates cancer. More common is for architectural distortion to be 'imaginary' in the perception of the radiologist."


I am confused as to what doctor you spoke to. Usually with a callback, a Radiologist immediately looks at the images and speaks to the patient. Do you not get your imaging done at a center with a Radiologist?

I would suggest that you get a copy of the imaging reports - both the original report and the report from the callback. The way that things are worded on the report, and the BIRADs rating, will give a good idea of the level of concern. Usually a 6 month follow-up is associated with a BIRADs3 rating, which means that the imaging presents a 2% or less risk of cancer. A biopsy (i.e. tissue diagnosis) is recommended, and a BIRADs4 is assigned, for anything with a greater risk than 2%.

Hopefully this turns out to be a false alarm. Moving forward, you might want to talk to a genetic counselor about further genetic testing. Are there any family members on your mother's side of the family who have had breast cancer or a different type of cancer? While the BRCA genes are the ones most commonly associated with breast cancer, these days many women with a strong family history of breast cancer are given a 'full panel' test, which can include as many as 30 different genes, all with some level of association to an increased breast cancer risk. Based on your complete family history, a genetic counselor could advise whether a full panel test might be appropriate for you.

Let us know what the Radiologist says.

“No power so effectually robs the mind of all its powers of acting and reasoning as fear.” Edmund Burke
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Sep 15, 2020 12:29PM Bellamom wrote:

I go to a breast imaging center run by a breast surgeon. I go in and get mamo, ultrasoimd and see him every six months. Every other time I go I get the u;translunar only.Then it goes out to the radiologist for his review. This time the ultrasound and mamo looked good to him but the radiologist said architectural distortion. I was called back for spot compression of right breast. I did that yesterday and now I have to wait again. The breast surgeon still didn't see anything. So confusing and so worrisome. I spent my morning crying. He wasn't worried and said I'd come back in six months for another mamo. When I got home and googled it I was shocked that it is not nothing to worry about. It is not a good thing to have. It's something that is a problem. Ugh

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Sep 21, 2020 02:43PM himoc918 wrote:

I received a call back for a diagnostic mammogram /US due to architectural distortion in late August which I had never heard of before. I googled it and couldn't believe what I was reading. After the diagnostic mammogram I was told come back in 6 months, but like you I am worried. Wishing you much luck.

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Sep 21, 2020 03:23PM Beesie wrote:

Bellamom, why do you go to an imaging center run by a breast surgeon? Have you had breast cancer?

Radiologists are doctors specifically trained to do breast imaging. My breast surgeon, the head of breast cancer surgery at a major cancer hospital, would never think of doing or even interpreting breast imaging for himself. It's not his area of expertise. He always defers to the Radiologist on anything related to imaging and needle biopsies.

As for architectural distortion, it can be a sign of a problem, but more often it turns out to be nothing. Did you have the spot compression today done by a Radiologist or again at the breast surgeon's imaging center? Usually the Radiologist reads callback imaging on the spot and speaks to the patient or has the tech tell the patient if everything is clear. It's unusual to have to wait for the results on a callback.

“No power so effectually robs the mind of all its powers of acting and reasoning as fear.” Edmund Burke
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Sep 21, 2020 04:17PM Bellamom wrote:

I go to a breast center run by a breast surgeon. He was trained at Sloan Kettering and has had this center over 20 years. People come from all over the unite states to see him.. he does the mamo and sonogram at the center and then you see him and he looks at both and gives you an exam.I’ve gone to him for about 17 years. So I had both in August and then I got the call that the radiologist said to come back for spot magnification. I did that last Monday .now I’m waiting, I haven’t had breast cancer before. But my mom did..ive also tested for BRCA and it was negative. I go to him every six months because my mom had breast cancer. Now I’m still waiting for a call with my results. I never realized it’s problematic that the radiologist is not on site until now that I have an issue. I’m scared to call them. But I’ll have to if I don’t hear from them.

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Sep 21, 2020 05:42PM Beesie wrote:

Bellamom, I probably shouldn't say this, but it sounds to me that you've been seeing a Breast Surgeon who has an income generating imaging business on the side. The fact that the facility doesn't have a Radiologist on board yet they actually have to send the imaging out to a Radiologist clearly suggests that imaging is not the primary expertise of this surgeon (nor should it be; a surgeon's expertise should be surgery).

I'm a bit surprised that with no personal history of breast cancer and no high risk condition (I'm assuming, since you haven't mentioned anything) you get screening every 6 months, although depending on your age that's probably good with your mother's history. May I ask how you are? For how many years have you been getting twice a year screenings? It's odd if you've been screened so extensively that despite your mother's young age at time of diagnosis, the only genetic testing you've had is for the BRCA genes. How long ago was this genetic testing done? If it wasn't done recently, it should be redone - new mutations of the BRCA gene are regularly found. And as I said in my earlier post, you should be tested for other genes that increase breast cancer risk. There is a lot more than just BRCA that can increase risk.

I'm sorry you are facing this uncertainty, and the wait for the callback results. Hopefully this turns out to be a false alarm and everything is fine.

“No power so effectually robs the mind of all its powers of acting and reasoning as fear.” Edmund Burke
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Sep 21, 2020 06:43PM Bellamom wrote:

I do not know if he makes money off the imaging and frankly I don’t care. That doesn’t even concern me. I’m case you haven’t noticed every doctor does that whether you realize it or not. That’s why these pharmaceutical reps make so much money running around from doctor to doctor trying to get them to push their drugs. It’s this point I’m sure he’s got more money than he knows what to do with. He’s quite well known in New York and has patients travel from all over to see him.,funny you even mention this,I had went to a walk in doctor around the holidays. They gave me some test that I didn’t even know about and charged over 1000 for,it.i thought it was just a strep test which was what they told me. Also,they sent it to a lab where I’m not covered. I went crazy. I called them when I got the bill. They wrote off the balance but it’s obvious that doctor has a deal,with that lab. I do not have a personal history but my mom had it. When you watch your mom suffer and eventually die due to it you will most certainly make sure to b extra cautious. I hate going. And yet I go every six months. I’m trying to b on top of it. I’ve had screenings over 15 years twice a year. As far as genetic testing sure I could get all kinds of testing done but I choose not to. What would I do? What would I change? Do,I get body parts or organs removed? That’s why I don’t do it. I eat healthy and juice daily. I do the best I can.

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Sep 22, 2020 09:11AM Bellamom wrote:

I’m ok. All,is good. Just density..yay... benign Birads two

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Sep 22, 2020 11:28AM Beesie wrote:

Bellamom, great news! Thanks for letting us know.

And by the way, I'm in Canada so around here the breast surgeons don't have their own imaging facilities and don't make money on imaging, at least none that I've ever encountered in 40 years. They leave the imaging to the experts, the Radiologists. I did live in the U.S. for a few years and after a callback was referred to a BS who wouldn't see me unless I had my imaging redone at her facility - and I'd literally just had a mammogram and ultrasound done at an imaging center a week before. I hightailed it back to my BS in Canada and had everything resolved (I had a large cyst that was aspirated) in a 10 minute appointment.

As for genetic testing, you have to do what you feel comfortable doing. I only mentioned the other genes because you mentioned that you'd had BRCA testing and been found to be negative. That doesn't mean a whole lot now that we know that there are so many other genetic mutations that might increase breast cancer risk.

“No power so effectually robs the mind of all its powers of acting and reasoning as fear.” Edmund Burke
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Sep 22, 2020 11:34AM Bellamom wrote:

Thank you so much! I’m over the moon thrilled.

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