Radial scar with microcalcifications: radiologic-pathologic correlation

Since it is widely recognized that a radial scar of the breast can mimic scirrhous carcinoma at mammography, criteria to differentiate the two lesions continue to be suggested. Mammographic features that have been described as occurring with radial scars include a radiolucent central core; elongated, radiating spicules; and absence of calcifications. Recent studies have documented the unreliability of the first two parameters; calcifications, however, have been reported to be unusual in mammograms of radial scar lesions. From recent case material, the authors present four cases of biopsy-proved radial scars associated with mammographically visible microcalcifications. The mammographic findings, with pathologic correlation, are reported to emphasize the occurrence of microcalcifications within radial scars. When a stellate lesion is seen at mammography in the absence of a surgical scar, biopsy should be performed promptly, since no reliable mammographic features exist to distinguish radial scars from scirrhous carcinomas.