[Underestimation of pure radial scars: A retrospective evaluation in a cancer center]

Radial scars (RS) are benign lesions, but their imaging appearance can mimic that of carcinoma. Traditionally, most RS were surgically excised due to the risk of underestimation. However, guidelines now exist allowing for their surveillance. The objective of this study was to evaluate the risk of underestimation and, secondarily, to identify associated risk factors, as well as to describe the proportion of women who developed breast cancer during follow-up.

This was a single-center, retrospective, observational study conducted using data from patients who underwent biopsies identifying RS in a cancer center between January 2000 and December 2015.

A total of 116 biopsies revealing radial scars without atypia were analyzed. Seventy patients underwent excision (66 [56.9%] via segmentectomy and 4 [3.4%] via vacuum-assisted biopsy), among which 55 were classified as "pure" radial scars (78.6%), 13 as radial scars with atypia (18.6%), and 2 as ductal carcinoma in situ (2.9%). The overall underestimation rate was 21.4%. The underestimation rate for carcinoma (in situ or invasive) was 2.9%. No predictive factors for underestimation were identified in our study. Follow-up data were available for 72 patients, among whom 12 (16.7%) developed breast cancer.

Our study shows an underestimation rate of 21.4% for radial scars, with no predictive risk factors identified, emphasizing the importance of multidisciplinary team discussions.