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Updated: Nov 11, 2025
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Published on: September 20, 2020
Upstage rate of radial scar/complex sclerosing lesion identified on core needle biopsy
Rachel Q Liu1, Leo Chen2, Amie Padilla-Thornton3
1Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, ON, N6A 5A5, Canada; Providence Breast Centre, Mount Saint Joseph Hospital, 3080 Prince Edward Street, Vancouver, BC, V5T 3N4, Canada.
Background:
We assessed the cancer upstage rate of Radial Scars (RS), and Complex Sclerosing Lesions (CSL), and risk-stratified lesions based on radiological and pathological features.
Methods:
Characteristics of RS/CSL treated from 2013 to 2018 were examined for features associated with cancer.
Results:
78 RS/CSL were found on core needle biopsy (CNB) and surgically excised. 9 (11.5%) lesions were upstaged. Upstaged patients were older (66 vs 51, p = 0.033). More upstaged lesions were accompanied by a mass on both mammography (87.5% vs. 30.0%, p = 0.005) and ultrasound (100.0% vs. 62.8%, p = 0.043). 20.5% of lesions biopsied under ultrasound guidance with small needles (14-18G) were upstaged, but no lesions biopsied under stereotactic guidance with large needles (9-12 G) with vacuum assistance were upstaged (p = 0.009).
Conclusions:
Excision of RS/CSL seen on CNB is warranted, especially if the patient is older, the CNB is performed under ultrasound guidance with small needles, or if a mass is present on imaging.
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