Radial scar: from conventional imaging to the new techniques. Case reports

Area of Science:

• Radiology
• Oncology
• Pathology

Background:

• Radial scars are complex benign breast lesions that can mimic malignancy mammographically.
• Accurate assessment of radial scars is crucial for appropriate patient management and avoiding unnecessary biopsies.

Purpose of the Study:

• To evaluate the role of MR-mammography in characterizing radial scars.
• To compare MR-mammography findings with histopathological results in patients with radial scars.

Main Methods:

• Four female patients with mammographic findings suspicious for radial scar underwent dynamic MR-mammography.
• MR-mammography findings were analyzed for lesion characteristics, including enhancement patterns and signal intensity curves.
• Histopathological results were used as the gold standard for comparison.

Main Results:

• MR-mammography identified focal enhancing lesions with irregular margins and specific signal intensity curve patterns in all four patients.
• Histopathology revealed one case of infiltrating lobular carcinoma, one of atypical hyperplasia, and two of typical hyperplasia.
• While MR-mammography improved assessment of lesion extent and margins compared to mammography, it could not differentiate between malignant and benign lesions in this small cohort.

Conclusions:

• MR-mammography provides detailed imaging of radial scars but has limitations in differentiating malignancy from benign hyperplasia.
• Surgical excision remains the recommended management for lesions suggestive of radial scar due to potential malignancy.
• Further research with larger cohorts is needed to establish the definitive role of MR-mammography in radial scar assessment.