The options listed above are not treatments, per se, but next steps after identification of Architectural Distortion (AD) using conventional/digital mammography, which produces a 2D image of breast tissue.

The research recommends digital breast tomosynthesis (DBT) mammography, which takes multiple X-rays of breast tissue from various angles to produce a 3D imagehttps://www.yalemedicine.org/conditions/digital-breast-tomosynthesis#:~:text=Conventional%20mammography%20produces%20a%202D%20image%20of%20breast,examine%20to%20look%20for%20signs%20of%20breast%20cancer. Based on research, the pooled predictive positive value (PPV) for malignancy of AD on DBT without a known cause is 34.6%, warranting tissue sampling using biopsy.https://isitforme.health/browse/dx/architectural-distortion-breast/article/treatments/digital-breast-tomosynthesis?pmid=32966111. DBT is also effective at guiding biopsieshttps://isitforme.health/browse/dx/architectural-distortion-breast/article/treatments/biopsy?pmid=33420200 and is more effective than stereotactic vacuum-assisted biopsyhttps://isitforme.health/browse/dx/architectural-distortion-breast/article/treatments/digital-breast-tomosynthesis?pmid=30511909

Ultrasound is recommended to accompany DBT to find a correlatehttps://isitforme.health/browse/dx/architectural-distortion-breast/article/treatments/ultrasound?pmid=32966111, often a Breast Imaging Reporting and Data System (BI-RADS) 4 or 5 rating.https://isitforme.health/browse/dx/architectural-distortion-breast/article/treatments/digital-breast-tomosynthesis?pmid=28834441 In addition, the Gail Model is suggested as an additional adjunct to Ultrasound to determine malignancy.https://isitforme.health/browse/dx/architectural-distortion-breast/article/treatments/ultrasound?pmid=33384211

However, the latest research, Breast Contrast-Enhanced MRI (CE-BMR) may help to reduce the need for biopsy after diagnosis with a positive DBT. https://isitforme.health/browse/dx/architectural-distortion-breast/article/treatments/breast-contrast-enhanced-mri?pmid=35094984