Onkológia 1/2010

Radial scar of the breast – challenges of the diagnostics

Radial scar (RS) is a benign breast lesion, which clinical significance increased dramatically with the introduction of population based screening and preventive mammographic programmes. The exact pathogenesis of RS is unknown. Histologically, RS is characterised by a fibroelastotic core with entrapped ducts and with radially surrounding ducts and lobules. Postmortem studies indicate that these lesions are common in the population, especially in association with benign breast disease. The accumulated evidence is indicating that RS is frequently associated with atypia and/or the breast malignancy and may be an indipendent risk factor for the development of the breast carcinoma. Because currently we cannot reliably exclude malignancy in RS, excision biopsy is recommended. The core biopsy evaluation may be sufficient in selected patients by taking more specimens per lesion (best by vacuum mammothomy), followed by close mammographic surveillance every 6 months during 2 years to prove the stability of the process.

Keywords: radial scar, complex sclerosing lesion, mammography, pathology