The Challenge of Digital Breast Tomosynthesis-Detected Architectural Distortion of the Breast: Inter-reader Variability and Imaging Characteristics That May Improve Positive Predictive Value.

Objective: To compare readers' performances when detecting architectural distortion (AD) on digital breast tomosynthesis (DBT). To determine the risk of malignancy of DBT with synthetic mammogram (SM)-detected AD and evaluate imaging features that are associated with malignancy risk.

Methods: This IRB-approved retrospective review included all cases of DBT-detected AD that were recommended for biopsy from October 2013 to July 2019.