spiculated,arch.distortion,micalcif

Hi, I am 60y/o fem. with recent mammogram. Report IMP: Spiculated mass with architc. distortion in the URQ of R breast with additional microcal.'s in this region.RN,mature,want truthful info
1.with the above report, it is highly likely that mass is malignant. Correct?
2.Did not have ultrasound; would ultras. perhaps show cyst, or dispute current findings?
3.please give simple explanat. of arch. distortion.
4. Tons of medical problems.Qality of life not good. If I refuse Tx, knowing that there are huge variables, approx how long could I live? Do many pts. refuse Tx?
5.How accurate is large needle bx w.guided ultrasound? Miss some? Having 5 tissue samples.
6.Live in San Anton. TX; near MD Anderson/Houston. If I have Tx-which would you recommen?
You guys at Cleveland rock! Thank you so much. God bless.

[Cleveland Clinic]

Dear laurieRNBSN:  
1.  There are features of the report that give high suspicion for malignancy.
2.  Ultrasound may differntiate a solid from cystic mass.  If this mass appears solid on mammogram, an ultrasound may not add much.
3.  Architectural distortion is the appearance on a mammogram of tissue spicules without an associated mass. The differential diagnosis of an area of architectural distortion includes scarring from previous surgery, radial scar, and carcinoma.
4.  Very few patients refuse treatment and prognosis is impossible to determine as we don't even know for sure if this is malignant.  Even if we knew more information, it is impossible to predict.  Assuming this is malignant, there is no information at the moment to lead us to believe this could not be cured with treatment.
5.  If the large needle hits the target, the biopsy should be accurate.  
6.  In most cases, breast cancer can be well treated close to home.  Many variables influence where care is received including family support, insurance coverage, etc.  Ultimately, you need to go where you feel comfortable.