Radial scars, despite their name, are not true scars but rather benign (non-cancerous) areas of hardened breast tissue. While the term “scar” might sound concerning, radial scars are not typically formed from injury or surgery. They are generally considered benign growths that do not cause symptoms and often cannot be felt.
What Are Radial Scars?
Radial scars are also known as complex sclerosing lesions, with the term “radial scar” often applied to lesions smaller than 1 cm and “complex sclerosing lesion” to those larger than 1 cm. These lesions feature a central fibrous core from which ducts and lobules radiate outwards, creating a star-like appearance on imaging. This unique configuration gives them their descriptive name, resembling a scar under a microscope or on a mammogram.
They are a type of benign architectural distortion of breast tissue, representing an unusual growth pattern. The exact cause of radial scars is not fully understood. They often contain various proliferative changes, such as duct hyperplasia or cysts, within their radiating structures.
Understanding Their Cancer Risk
While benign, radial scars are important due to their association with an increased risk of finding or developing certain breast conditions. This risk does not mean the radial scar itself transforms into cancer. Instead, it can be a marker for the presence of other higher-risk lesions, such as atypical hyperplasia, ductal carcinoma in situ (DCIS), or even invasive carcinoma, either within the radial scar or elsewhere in the breast.
The presence of atypical cells within a radial scar significantly influences this risk. Individuals with a radial scar may have a slightly increased lifetime risk of developing breast cancer compared to those without one. Their discovery often prompts further evaluation to exclude any co-existing or future high-risk conditions within the breast.
Diagnosis and Follow-Up
Radial scars are frequently identified incidentally during routine breast imaging, such as mammograms, or during biopsies performed for other reasons. Their appearance on imaging can sometimes mimic breast cancer, particularly due to their spiculated shape, making a definitive diagnosis crucial. A biopsy is typically necessary to differentiate a radial scar from malignancy.
While core needle biopsies can provide an initial diagnosis, surgical excision is often recommended. This is due to the possibility of sampling error, where a small area of co-existing malignancy or high-risk lesion might be missed. Surgical removal allows for a more complete examination to confirm the lesion’s benign nature and rule out any associated higher-risk conditions. Regular follow-up and continued breast screening are important for individuals with a history of radial scars.