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Pathology and clinical relevance of radial scars: a review

¹ Department of Pathology, The National Breast Screening Programme Eccles Unit and Mater Misericordiae University Hospital, Eccles St, Dublin 7, Ireland
² Department of Radiology, The National Breast Screening Programme Eccles Unit and Mater Misericordiae University Hospital
³ Department of Surgery, The National Breast Screening Programme Eccles Unit and Mater Misericordiae University Hospital

Correspondence to:
Dr M Kennedy, Department of Pathology, Mater Misericordiae University Hospital, Eccles St, Dublin 7, Ireland;
mkennedy{at}mater.ie
ABSTRACT
Radial scar (RS) is a benign, well recognised, radiological and pathological entity. Histologically, it is characterised by a fibroelastotic core with entrapped ducts and surrounding radiating ducts and lobules. Postmortem studies indicate that these lesions are present commonly in the population, especially in association with benign breast disease. In recent years, their clinical relevance has assumed more importance with the introduction of population based screening programmes. The exact pathogenesis of RS is unknown. Accumulating evidence indicates that they are associated with atypia and/or malignancy and, in addition, may be an independent risk factor for the development of carcinoma in either breast. In view of the association with atypia and malignancy, excision biopsy is justified in RS, although it has been argued that core biopsy evaluation and surveillance may be appropriate in selected patients.

Keywords: radial scar; complex sclerosing lesion; radiology; pathology; review

Abbreviations: DCIS, ductal carcinoma in situ; ER, oestrogen receptor; RS, radial scar

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