[Histomorphologic differentiation of "radical scars" of the breast]

Forty-six cases of radial scars (30 associated with carcinomas and 16 with benign changes) were classified according to the structure of the epithelial component. Common to all types was a fibrous center from which connective-tissue ramifications radiated outward. The smallest change of this kind was the lobular type, with radially arranged lobuli without any increase of epithelium. In the case of the proliferating ductile type there were ductus of various widths with proliferated epithelia between the ramifications. In benign conditions, their value depends on the degree of the cell and/or structural atypia. Their occurrence in carcinoma cases was interpreted as an accompanying phenomenon of the common proliferation process. Radial scars of the tubular type usually exhibited well differentiated tubular structures of uniform width, again radiating outward. Due to their similarity with tubular carcinomas and the fact that transitional forms have been observed, the present authors agree with others that this type of radial scar is to be regarded as a facultative original lesion in the pathogenesis of tubular carcinoma. On the basis of long-term follow-up studies by other authors following local excision, local removal of radial scars may be regarded as an adequate therapy. In a critical review of the cases reported in the literature the authors discuss differences in nomenclature and the sometimes divergent views regarding tumor maturity.