Meta-analysis: Architectural distortion and breast MRI

Breast Dis. 2022;41(1):205-214. doi: 10.3233/BD-210045.


Background: The implementation of digital breast tomosynthesis has increased the detection of architectural distortion (AD). Managing this finding may be experienced as a clinical dilemma in daily practice. Breast Contrast-Enhanced MRI (CE-BMR) is a known modality in case of problem-solving tool for mammographic abnormalities. However, the data about AR and CE-BMR are scant.

Objective: The purpose was to estimate the benefit of CE-BMR in the setting of architectural distortion detected mammographically through a systematic review and meta-analysis of the literature.

Methods: A search of MEDLINE and EMBASE databases were conducted in 2020. Based on the PRISMA guidelines, an analysis was performed using the chi-square test of independence to determine if there was a significant association between the result of the test (positive or negative) and the participant condition (malignant or non-malignant).

Results: Four studies were available. The negative predictive value (NPV) was 98.3% to 100%. The result of the chi-square indicated that there was significant association between the participant test result and the participant condition for the included publications (X(1,175)2= 84.051, p = 0.0001).

Conclusions: The high NPV could allow for deferral of a biopsy in favor of a short-interval imaging follow-up in the setting of a negative CE-BMR.

Keywords: Breast; MRI; architectural distortion; mammogram; tomosynthesis.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Breast / diagnostic imaging*
  • Breast Neoplasms / diagnostic imaging
  • Contrast Media
  • Female
  • Humans
  • Magnetic Resonance Imaging*
  • Predictive Value of Tests


  • Contrast Media