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Radial Sclerosing Lesion (Radial Scar): Radiologic-Pathologic Correlation.
Pamela Yan1, Gregory Bean2, Jean Bao3
1Department of Radiology, Stanford University School of Medicine, Stanford, CA, USA.
Journal of Breast Imaging
|August 29, 2024
Summary
Radial sclerosing lesions (RS) and complex sclerosing lesions (CSL) are rare breast abnormalities. Careful evaluation of imaging and pathology is crucial for determining management, as malignancy upgrade is possible, especially with atypia.
Area of Science:
- Breast imaging and pathology
- Oncology
- Radiology
Background:
- Radial sclerosing lesions (RS) and complex sclerosing lesions (CSL) are uncommon breast findings.
- Their incidence at core needle biopsy is less than 1%.
Purpose of the Study:
- To review recent literature on RS/CSL.
- To discuss radiology and pathology findings of RS/CSL.
- To inform appropriate management strategies for these lesions.
Main Methods:
- Review of recent scientific literature.
- Analysis of radiological imaging features (tomosynthesis, ultrasound).
- Histopathological examination of RS/CSL.
Main Results:
- RS/CSL detection is increasing with tomosynthesis, often appearing as architectural distortion.
- Ultrasound findings are typically subtle or occult.
- Malignancy upgrade rates vary: 16-29% with atypia, <3% without atypia (≤1 cm).
Conclusions:
- Surgical excision is essential for RS/CSL with atypia due to significant upgrade risk.
- For RS/CSL without atypia and ≤1 cm, imaging follow-up may be considered.
- Distinguishing benign RS/CSL from malignancy requires careful correlation of imaging and pathology.
