Abnormal mammogram: architectural distortion and need a biopsy?

I had a routine mammo that showed a suspicious area. I then had a diagnostic mammo and an US. US did not show anything, but diagnostic mammo conformed. I then had a mamo guided biopsy which confirmed DCIS with architectural distortion. That means the duct is "clogged"/so full that it is bulging.
You did not mention any other terms or DCIS. That was all the report indicated?

Have you gone ahead and had the biopsy? I haven't had your exact experience but do know firsthand how stressful testing and diagnostics can be. Fill us in a bit if you feel like it and tell us how you are doing.

Ultra sounds are not the best primary diagnostic…it is best used in conjunction with mammogram. Diagnostic mammogram is the gold standard test for breast cancer. Sometimes because of different structural conditions ultrasound is used to get a different view. I would absolutely get that biopsy.
Biopsies are easily completed in less than an hour, most of the time is spent prepping for the procedure. I did not have pain with my biopsies they are done under mammogram. And there is a good chance that what is in your duct is negative for cancer.
Please get the biopsy 🥰

My biopsy was life saving.

It is worth it.

Personally I would get the biopsy. It is a very minor procedure. Not to scare you but there are breast cancers that can show as architectural distortion without a "lump" or obvious mass. I think they say around 80% of biopsies are normal/benign, but its important to know what's going on. You could also ask for breast MRI - it can show things that a mammo or ultrasound can't see. The only way to really know though is to get the biopsy so they can look at the tissue, and as @susan7656 said, biopsies can be life saving sometimes.

I thought I commented earlier but maybe not. My august mammogram showed an architectural distortion. I think the term is often used with lobular cancer. The ultrasound did not show it. No correlation, but the second mammogram still picked it up, with a second radiologist reading it. I went for a stereotactic breast biopsy. You sit up and the needle takes a sample. It almost feels like a mammogram. The report was malignant and I've had surgery and 3 wks radiation. I'm very grateful to the first doctor who found that tiny ripple and sent him a thank you note! He saved me from more extensive surgery. My medical oncologist looked at the film and said, "I can't even see it." Exactly. Very tiny.

Architectural distortion on mammogram. Additional imaging recommended biopsy. Lumpectomy recommended after biopsy and it was done. Benign.
A year later, mammogram clear.
This year, 2 years post lumpectomy, they said increased distortion and recommended further imaging. Can it just be scar tissue from the lumpectomy?
I’m scheduled for further imaging.

Routine annual mammogram 2024 showed "distortions" mainly in the right breast but I had questionable areas in both breasts. Sonogram and breast MRI done, 4 biopsies recommended under guided mammogram. Not fun but no choice but to have all biopsies done. They referred to my breasts as "busy"...one invasive area (at the time, right breast), 2 areas of in-situ (both breasts) and 2 areas of abnormal ductal hyperplasia, both breasts. 70 years young, lifetime history of dense breasts and microcalcifications...my 2023 mammogram was normal. I had no symptoms of BC at all. Was shocked with results. No family history of BC nor any cancer. After much deliberation, bilateral mastectomy in May with 1 positive lymph node. Final pathology revealed invasive BC in left breast as well. Early stage, oncotype testing was good, low reoccurrence risk. Chemo and radiation not indicated for me. Started Anastrozole June 24, so far joint pain & headaches. Afraid of developing osteoporosis and I am a ischemic heart patient as well. Certainly high risk but cardiologist gave the go ahead to start this AI.
Between a rock & a hard place. Some women would say don't bother with the AI, your profile looks good.
But not taking any chances. Go for the biopsies! If there ever was a woman who was considered "low risk" for breast cancer it was me. Within one year my breasts developed multiple sites of BC or areas ready to develop BC. Go for the biopsies! Pathology will give you the real story, right now you are operating in the dark.
Get the biopsies! If I had skipped my annual mammogram in 2024...my surgeon said within 1-2 years I would have been a stage 4. And, I believe, she knew what she was talking about. I associated myself with Memorial Sloan Kettering, in NYC. The 2nd best cancer center in the country (1st is MD Cancer Care Center, in Texas).
Traveling was a pain the neck for sure. But worth it. Go for the biopsies. Be brave, it's scary for sure but your life depends on finding out the very best information you can. The very best of luck to you!

My diagnostic mammogram and US showed what they labeled as possible folded lymph node, no calcifications, wait 6 months. After thinking about it for a month, I asked for a biopsy. It was a 1.6 cm DCIS. I switched my care to MD Anderson in Houston.

In 2017 when I was 70, my screening mammogram also showed architectural distortion also. For the 2 years before I had mammograms every 6 months because of calcification. I had further imaging and 2 sites were found. A biopsy determined one ductal and one lobular ER PR + Her2- in my left breast. I had a mastectomy on that one breast. Onco test was 18. So no chemo. I did take Letrozole for 5 years. No problems until my screening mammogram on my right breast this past April (2025). The report said focal asymmetry, but come back in a year. I contacted my oncologist and she ordered further imaging. That imaging indicated a small tumor 9mm. I had a biopsy. It came back triple negative invasive ductal carcinoma(TNBC). This is more aggressive. I had a mastectomy on the right breast June 18, clean margins and no lymph node involvement.The plan is to start chemo so since that is the standard treatment for this cancer. I do have a consult scheduled at Mayo in a couple of weeks. I am 78. I have been active walking 3 miles regularly and weight training 2x a week. I am not looking forward to this journey. But, I have a fantastic, supportive husband who is my rock. We will get through this.