Preoperative estimation of the pathological breast tumor size in architectural distortions: a comparison of DM, DBT, US, CEM, and MRI

Question Identifying the most accurate imaging technique for preoperative tumor staging of architectural distortions (ADs) is crucial now that contrast-enhanced mammography (CEM) is widely implemented. Findings Measuring thin wispy spicules in ADs on digital (DM) and digital breast tomosynthesis (DBT) should be avoided, as they consistently overestimate pathological tumor stage. Clinical relevance Precise tumor size estimation in ADs is critical for proper staging and treatment planning. This study favors the use of DBT excluding thin spicules, CEM, and magnetic resonance imaging (MRI) for optimal accuracy.