A radial scar in the breast is a benign lesion, sometimes referred to as a complex sclerosing lesion. This breast finding is not a true scar from injury or surgery. Instead, its name comes from its distinct star-like appearance under a microscope. It represents a localized area of hardened tissue within the breast.
Understanding Radial Scar
A radial scar is characterized microscopically by a central core of fibrous tissue. From this core, normal breast structures like ducts and lobules radiate outwards. This growth pattern gives the lesion its star-shaped or spiky appearance. The term “radial scar” describes this architectural distortion.
The structure of a radial scar can sometimes mimic the appearance of breast cancer on imaging studies. This resemblance is due to radiating spicules, seen in both radial scars and certain types of breast cancer. Its visual similarity means further investigation is often needed for an accurate diagnosis.
How Radial Scars Are Diagnosed
Radial scars are typically discovered incidentally during routine breast imaging, such as mammograms, ultrasounds, or MRIs. These lesions usually do not cause noticeable symptoms like a palpable lump or pain. Their appearance on imaging can be concerning, often presenting as a spiculated mass or architectural distortion, features also associated with malignant tumors.
To confirm the diagnosis and distinguish it from cancer, a biopsy is necessary. This procedure involves taking tissue samples from the suspicious area, typically via a core needle biopsy guided by imaging. In some cases, an excisional biopsy, which removes the entire lesion, may be performed. A pathologist then examines the tissue under a microscope to identify characteristic features of a radial scar and rule out cancerous cells.
Managing a Radial Scar Diagnosis
Following a radial scar diagnosis, management typically involves careful consideration. Some studies indicate a slightly increased risk of developing breast cancer over time. This risk is particularly noted if the radial scar is found alongside other high-risk cellular changes, such as atypical ductal hyperplasia (ADH) or atypical lobular hyperplasia (ALH). These atypical cells represent abnormal but non-cancerous growth.
Due to the possibility of associated high-risk cells or an underlying malignancy not fully captured by a biopsy, surgical excision of the radial scar is often recommended. This allows for a complete examination of the tissue to ensure no cancerous or more advanced high-risk cells are present. If atypical cells or cancer are identified after excision, further treatment may be necessary. Regular follow-up imaging and clinical examinations are generally advised to monitor breast health after a radial scar diagnosis.