All radial scars/complex sclerosing lesions seen on breast screening mammograms should be excised

Fasih, Tarannum; Jain, Megha; Shrimankar, Jyotsna; Staunton, Marie; Hubbard, Johnathan; Griffith, Clive

doi:10.1016/j.ejso.2005.04.004

Cited by 50 publications

(37 citation statements)

References 18 publications

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“…9 The incidence of premalignant or malignant histology in radial scars in this study is comparable with rates reported in the literature. Fasih et al 10 have reported rates from the Newcastle breast screening programme of 67% for pure radial scars, 17% for ADH and 16% for in situ or invasive carcinoma, compared with 68%, 18% and 14% (including LCIS), respectively, in this study. Lower, but comparable, results have been shown in a retrospective analysis of 175 patients with screen-detected radial scars, 11 showing concurrent carcinoma in 3% and carcinoma in situ in 5% (5% and 7%, respectively, in this study).…”

Section: Discussionmentioning

confidence: 58%

A review of needle core biopsy diagnosed radial scars in the Welsh Breast Screening Programme

Osborn

Wilton

Stevens

et al. 2011

annals

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INTRODUCTION Radial scars are benign breast lesions; their appearance on mammography may, however, mimic carcinoma. Needle core biopsy is performed for pre-operative diagnosis and, currently in Wales, all lesions with benign biopsy results are surgically excised. We have reviewed all cases of needle core biopsy-diagnosed radial scars from the Welsh breast screening programme, Breast Test Wales (BTW), and investigated the outcome of radial scars based on histology from surgical excision in order to evaluate the appropriateness of the current management of these lesions in Wales. PATIENTS AND METHODS All needle core biopsy diagnosed radial scars were identified from the BTW screening database from the start of screening in 1989 until the end of 2007. RESULTS A total of 118 patients were diagnosed with radial scars on needle core biopsy; two patients had bilateral radial scars. Median patient age was 54 years (range, 49-68 years). Ninety-five lesions (79%) were thought to be pure radial scars on needle core biopsy; however, only 81 pure radial scars were identified on excision biopsy histology. Carcinoma was present in seven patients and ductal carcinoma in situ in nine patients at excision biopsy. In two patients, the cancers occurred in lesions reported as pure radial scars on needle core biopsy. Twenty-two lesions showed atypical ductal or lobular hyperplasia (ADH/ALH) or both on excision biopsy; 14 of these lesions were classed as pure radial scars by needle core biopsy. CONCLUSIONS All core biopsy diagnosed radial scars, presenting as screen detected abnormalities, should be excised due to their association with premalignant and malignant conditions.

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Section: Discussionmentioning

confidence: 58%

A review of needle core biopsy diagnosed radial scars in the Welsh Breast Screening Programme

Osborn

Wilton

Stevens

et al. 2011

annals

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“…However, because no absolute mammographic criteria can be used to distinguish a RS or complex sclerosing lesion with associated benign epithelial proliferations from one containing carcinoma, 7,31-35 current practice supports performance of multiple stereotactic core needle biopsies 36,37 to fully evaluate lesions that are radiographically consistent with RS or complex sclerosing lesions. [2][3][4] Only in cases in which atypia is absent and there is good mammographic-pathologic correlation can an excisional biopsy be foregone. 37 If atypical hyperplasia or carcinoma in situ is present, then the treatment and prognostic implications of these particular lesions should apply.…”

Section: Discussionmentioning

confidence: 99%

“…When such lesions are greater than 1.0 cm in size, they have been termed "complex sclerosing lesions." 2,5 The finding of carci-noma in some RS, 6 -8 especially tubular carcinomas, also has been reported.…”

mentioning

confidence: 98%

“…However, with the widespread institution of mammographic screening programs, larger RS can be detected and may be virtually indistinguishable mammographically from small invasive carcinomas. [2][3][4] Histologically, RS are characterized by a region of central sclerosis surrounded by a variety of epithelial proliferative lesions, apocrine and cystic changes, and papillomas extending radially from a central zone of sclerosis. When such lesions are greater than 1.0 cm in size, they have been termed "complex sclerosing lesions."…”

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confidence: 99%

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Interdependence of radial scar and proliferative disease with respect to invasive breast carcinoma risk in patients with benign breast biopsies

Sanders

Page

Simpson

et al. 2006

Cancer

105

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“…Patterson y cols 17 en lesiones catalogadas como cicatriz radiada observaron carcinoma in situ en 16,9% en los casos sintomáticos y en 4,7% de los casos detectados por tamizaje mamográfico. Producto del mayor riesgo de asociación de cicatriz radiada con cáncer, algunos autores recomiendan la extirpación completa de las lesiones 18 .…”

Section: Discussionunclassified

Validez diagnóstica de la biopsia intraoperatoria en cirugía de lesiones mamarias palpables

et al. 2009

Rev. méd. Chile

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All radial scars/complex sclerosing lesions seen on breast screening mammograms should be excised

Cited by 50 publications

References 18 publications

A review of needle core biopsy diagnosed radial scars in the Welsh Breast Screening Programme

A review of needle core biopsy diagnosed radial scars in the Welsh Breast Screening Programme

Interdependence of radial scar and proliferative disease with respect to invasive breast carcinoma risk in patients with benign breast biopsies

Validez diagnóstica de la biopsia intraoperatoria en cirugía de lesiones mamarias palpables

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