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Radial scars and complex sclerosing lesions on core needle biopsy of the breast: upgrade rates and long-term outcomes

  • Epidemiology
  • Published:
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Abstract

Purpose

Radial scars and complex sclerosing lesions of the breast are part of a group of “indeterminate” breast lesions, which are excised due to risk of coexistent carcinoma. The aim of this study was to assess rate of upgrade of these lesions to invasive and in situ carcinoma and to quantify the risk of development of subsequent cancer in women diagnosed with these lesions.

Methods

A retrospective review of a prospectively maintained breast screening database was performed. All patients with radial scar identified at either core biopsy or final excision biopsy between January 2006 and July 2012 were identified. Full pathological reports for both core biopsy and final excision biopsy were reviewed. Patient outcomes were followed for a mean of 117.1 months.

Results

Of 451 B3 biopsies performed at our screening unit, 95 (22%) were found to have a radial scar or complex sclerosing lesion (CSL) on core needle biopsy. Within this group, 77 had no atypia on CNB, with 7 (9%) upgraded to invasive/in situ carcinoma on final excision. Of nine with definite atypia on CNB, 3 (33%) were upgraded. In those patients without atypia or malignancy on final excision, 7.5% developed cancer during 10-year follow-up.

Conclusion

Patients with radial scar with atypia have a higher risk of upgrade to malignancy. Further research is needed to identify which patients may safely avoid excision of radial scar. Patients with a diagnosis of radial scar on CNB are at increased subsequent risk of breast cancer and may benefit from additional screening.

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Funding

The authors declare no funding source.

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Authors and Affiliations

  1. Department of Surgery, Breastcheck Eccles Unit, Eccles St, Dublin 7, Ireland

    E. M. Quinn, E. Dunne, M. Stokes, M. J. Barry, M. Kell & S. M. Walsh

  2. Department of Radiology, Breastcheck Eccles Unit, Eccles St, Dublin 7, Ireland

    F. Flanagan

  3. Department of Histopathology, Breastcheck Eccles Unit, Eccles St, Dublin 7, Ireland

    S. Mahon

Authors
  1. E. M. Quinn
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  2. E. Dunne
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  3. F. Flanagan
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  4. S. Mahon
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  5. M. Stokes
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  6. M. J. Barry
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  7. M. Kell
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  8. S. M. Walsh
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Correspondence to E. M. Quinn.

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The authors declare no conflicts of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. As this study involved retrospective analysis of a database, formal ethics committee approval was not required.

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Quinn, E.M., Dunne, E., Flanagan, F. et al. Radial scars and complex sclerosing lesions on core needle biopsy of the breast: upgrade rates and long-term outcomes. Breast Cancer Res Treat 183, 677–682 (2020). https://doi.org/10.1007/s10549-020-05806-z

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  • DOI: https://doi.org/10.1007/s10549-020-05806-z

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