Architectural Distortion

I have fibrocystic breast and I have had 2 benign fatty tumors removed, one half-dollar size on the right, one small on the left when I was 19 & 24. I noticed pain in my left breast, its a little heavier than the other and some firmness when lying down and scheduled a physical.  My doctor did feel something, I am 40 and scheduled me for my first screening mammogram. I got called back in for a mag set and ultrasound, which both were inconclusive, mammogram was a Birad 3. Surgeon consultation results was I had a architectural distortion with no distinct mass or calcifications noticed at 9 o'clock left breast with some asymmetry. It is tender in the area that required further evaluation.

I have an Aunt that had breast cancer in her late 30's and my mom has had benign fatty tumors removed too.  Anything I read about architectural distortions is not good.  Is this really a bad thing and an indication of early stages of breast cancer?  The surgeon suggested to be close to 100% sure it is due to fibrocystic breast an MRI, but my insurance may not deem it medically necessary.  I do have an option for different types of biopsy but since there isn't a defined mass it could be hit or miss.  Is this something that I should choose to be biopsied to be safe and then monitored every 3-6 months. Should I be worried?

[zouzi]

Hi,
Architectural distortion is a broad term used to describe scarring-appearance in the breast and can mean many things, including benign diseases, e.g. radial scar (which is a benign lesion of the breast made up of fibrous and glandular tissue),injury,infection or following surgery.Sometimes,unfortunately it could also be an indication of breast cancer.
I am not sure I understand how your mammogram and ultrasound report was inconclusive, but stated that your BI-RADS score is a 3.
BI-RADS 3,means that your mammogram is probably normal,but a repeat mammogram should be completed in 6 months.This may also be needed if your radiologist does not have your baseline or previous mammogram for comparison.
If I were you I would choose to have a biopsy done, just to make sure, since your
doctor upon examination, he felt "something" in your breast.
As there is no perfect xray or scan, sometimes a biopsy is the only way to determine the cause of architectural distortion,or any other abnormality found in the breast.
I am sure that your surgeon will advise you if a biopsy is really needed at this time and which one would be best to have in your particular case.
Hoping that there is nothing really serious to worry about.  
Wishing you all the best...

[bluebutterfly2222]

Perhaps if your doctor a letter stating that an MRI is medically necessary, or else you will have to undergo a "hit or miss" biopsy, your insurance will agree to preauthorize the MRI?

[bluebutterfly2222]

One additional thought: there is a newer test,  BSGI (Breast Specific Gamma Imaging), that detects differently than mammography, ultrasound, or MRI. While those test look at the anatomy of a finding, this tests looks instead at "the way things work," (based on the fact that cancer cells absorb more of the tracer agent than normal cells).  If a mammogram or ultrasound cannot define the nature of a finding, this test can help make a diagnosis. It is especially useful when pts have multiple or suspicious lesions, or lesions that can be felt but not be detected on a mammogram or ultrasound.

I don't know if it's available in your area yet, or if you would be eligible for it (it is particularly indicated for women who have had a questionable mammogram, are at high risk for BC, have dense breast tissue or implants, have scars from previous biopsies, or are being monitored for cancer recurrence), but it might be something to look into...

Best wishes...