Evaluation of mammographic stellate lesions

Breast masses can be classified into circumscribed masses and stellate masses. Stellate masses are more difficult to detect but are easier to analyze. Good technique, proper processing, proper viewing conditions, and critical comparison of right vs. left and current vs. old can aid in the detection of stellate masses. Once detected, analysis is straightforward. Most will be scirrhous carcinomas. A few will be radial scars, traumatic fat necrosis, or rare benign lesions. Additional signs such as architectural distortion and microcalcifications can be very important. Additional views, including spot compression films, may be decisive. Not all stellate lesions are malignant, but most will require biopsy. Traumatic fat necrosis may be differentiated on the basis of history or radiographic appearance and does not need intervention. Lesions suspicious for carcinoma and radial scars should be excised and examined histologically.