Skip to main content
SpringerLink
Log in

Infiltrative Pseudo-malignant Lesions

  • Chapter
Benign Breast Diseases

  • 180 Accesses

Abstract

The term radial scar (“strahlige Narbe”) was introduced by Hamperl in 1975 to describe a lesion with a stellate configuration, which mammographically and pathologically mimics invasive carcinoma. This term is simple and avoids the use of other multiple synonyms, which do not always reflect the intrinsic pathological features. Some of the terms applied to the radial scar include: sclerosing papillary proliferation (Fenoglio and Lattes 1974), but papillary proliferation is not always present in these lesions; infiltrating epitheliosis (Azzopardi 1979), which has a malignant connotation, and indurative mastopathy (Rickert et al. 1981) and yet in the majority of cases the lesion is not always palpable. (1979) applied the term non-encapsulated sclerosing lesion.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution

Institutional subscriptions

References

  • Alder DD, Helvie MA, Oberman HA, Ikeda DM, Bhan AO (1990) Radial sclerosing lesion of the breast: mammographic features. Radiology 176:737–740

    Google Scholar 

  • Andersen JA, Gram JB (1984) Radial scar in the female breast: a long-term follow-up study of 32 cases. Cancer 53:2557–2560

    Article  PubMed  CAS  Google Scholar 

  • Anderson TJ, Battersby S (1985) Radial scars of benign and malignant breasts: comparative features and significance. J Pathol 147:23–32

    Article  PubMed  CAS  Google Scholar 

  • Azzopardi JG (1979) Over diagnosis of malignancy. Elastosis and other connective tissue changes. In: Problems in breast pathology. WB Saunders, Philadelphia, pp 167–191; 379–394

    Google Scholar 

  • Battersby S, Anderson TJ (1985) Myofibroblast activity of radial scars. J Pathol 147:33–40

    Article  PubMed  CAS  Google Scholar 

  • Bodian CA, Perzin KH, Lattes R, Hoffmann P, Abernathy TG (1993) Prognostic significance of benign proliferative breast disease. Cancer 71:3896–3907

    Article  PubMed  CAS  Google Scholar 

  • Carter DJ, Rosen PP (1991) Atypical apocrine metaplasia in sclerosing lesions of the breast: a study of 51 patients. Mod Pathol 4:1–5

    PubMed  CAS  Google Scholar 

  • Chan JK, Ng WF (1987) Sclerosing adenosis cancerized by intraductal carcinoma. Pathology 19:425–428

    Article  PubMed  CAS  Google Scholar 

  • Charafe-Jauffret E, Jacquemier J, Lelong B, et al. (2001) Mammary carcinoma arising in microglandular adenosis: a case report. Ann Pathol 21:435–438

    PubMed  CAS  Google Scholar 

  • Clement PB, Azzopardi JG (1983) Microglandular adenosis of breast: a lesion simulating tubular carcinoma. Histopathology 7:169–180

    Article  PubMed  CAS  Google Scholar 

  • Cohen MA, Sferlazza SJ (2000) Role of sonography in evaluation of radial scars of the breast. Am J Roentgenol 174:1075–1078

    CAS  Google Scholar 

  • Cosgrove DO, Svensson WE (2001) Ultrasound: imaging, dynamic and haemodynamic features. In: Tucker AK, Ng YY (eds) Textbook of mammography. Churchill Livingstone, New York, pp 217–240

    Google Scholar 

  • Cyrlak D, Carpenter PM, Rawal NB (1999) Breast imaging case of the day. Radiographics 19:245–247

    PubMed  CAS  Google Scholar 

  • Diaz NM, McDivitt RW, Wick MR (1991) Microglandular adenosis of the breast. An immunohistochemical comparison with tubular carcinoma. Arch Pathol Lab Med 115:578–582

    PubMed  CAS  Google Scholar 

  • DiPiro PJ, Gulizia JA, Lester SC, Meyer JE (2000) Mammographic and sonographic appearances of nodular adenosis. Am J Roentegenol 175:31–34

    CAS  Google Scholar 

  • Endoh Y, Tamura G, Kato N, Motoyama T (2001) Apocrine adenosis of the breast: clonal evidence of neoplasia. Histopathology 38:221–224

    Article  PubMed  CAS  Google Scholar 

  • Eusebi V, Foschini MP, Betts CM, et al. (1993) Microglandular adenosis, apocrine adenosis, and tubular carcinoma of the breast. An immunohistochemical comparison. Am J Surg Pathol 17:99–109

    Article  PubMed  CAS  Google Scholar 

  • Fechner RE (1981) Lobular carcinoma in situ in sclerosing adenosis. A potential source of confusion with invasive carcinoma. Am J Surg Pathol 5:233–239

    Article  PubMed  CAS  Google Scholar 

  • Fenoglio C, Lattes R (1974) Sclerosing papillary proliferations in the female breast. A benign lesion often mistaken for carcinoma. Cancer 33:691–700

    Article  PubMed  CAS  Google Scholar 

  • Fisher ER, Palekar AS, Kotwal N, Lipana N (1979) A non-encapsulated sclerosing lesion of the breast. Am J Clin Pathol 71:240–246

    PubMed  CAS  Google Scholar 

  • Fisher ER, Palekar AS, Sass R, Fisher B (1983) Scar cancers: pathologic findings from the National Surgical Adjuvant Breast Project IX. Breast Cancer Res Treat 3:39–59

    Article  PubMed  CAS  Google Scholar 

  • Foote FW, Stewart FW (1945) Comparative studies of cancerous versus noncancerous breasts. Ann Surg 121:6–53

    Article  PubMed  CAS  Google Scholar 

  • Franquet T, De Miguel C, Cozcolluela R, Donoso L (1993) Spiculated lesions of the breast: mammographic-pathologic correlation. Radiographics 13:841–852

    PubMed  CAS  Google Scholar 

  • Hamperl H (1975) Strahlige Narben und obliterierende Mastopathie. Beiträge zur pathologischen Histologie der mamma. Virchows Arch (A) Path Anat Histol 369:55–68

    Article  CAS  Google Scholar 

  • Jacobs TW, Bryne C, Colditz G, Connolly JL, Schnitt SJ (1999) Radial scars in benign breast biopsy specimens and the risk of breast cancer. N Eng J Med 340:430–436

    Article  CAS  Google Scholar 

  • Jacobs TW, Schnitt SJ, Tan X, Brown LF (2002) Radial scars of the breast and breast carcinomas have similar alterations in expression of factors involved in vascular stroma formation. Hum Pathol 33:29–38

    Article  PubMed  Google Scholar 

  • James BA, Cranor ML, Rosen PP (1993) Carcinoma of the breast arising in microglandular adenosis. Am J Clin Pathol 100:507–513

    PubMed  CAS  Google Scholar 

  • Jensen RA, Page DL, Dupont WD, Rogers LW (1989) Invasive breast cancer in women with sclerosing adenosis. Cancer 64:1977–1983

    Article  PubMed  CAS  Google Scholar 

  • Kay S (1985) Microglandular adenosis of the female mammary gland: study of a case with ultrastructural observations. Hum Pathol 16:637–641

    Article  PubMed  CAS  Google Scholar 

  • King TA, Scharfenberg JC, Smetherman DH, Farkas EA, Bolton JS, Fuhrman GM (2000) A better understanding of the term radial scar. Am J Surg 180:428–432

    Article  PubMed  CAS  Google Scholar 

  • Koenig C, Dadmanesh F, Bratthauer GL, Tavassoli FA (2000) Carcinoma arising in microglandular adenosis: an immunohistochemical analysis of 20 intraepithelial and invasive neoplasms. Int J Surg Pathol 8:303–315

    Article  PubMed  Google Scholar 

  • Kulka J, Davies JD, Chinyama CN (1996). Benign and malignant stellate lesions: structural differences in 5µm sections and thick tissue slices. Anticancer Res 16:3965–3970

    PubMed  CAS  Google Scholar 

  • Lanyi M (1986) Diagnosis and differential diagnosis of breast calcifications. Springer, Berlin Heidelberg New York, pp 45–50

    Google Scholar 

  • Linell F, Rank F (1989) Histogenesis (morphogenesis) of different types of breast carcinoma. In: Breast cancer. Werner Schmidt, Universitetsförlaget Dialogos, Lund, pp 18–68

    Google Scholar 

  • MacErlean DP, Nathan BE (1972) Calcification in sclerosing adenosis simulating malignant breast calcification. Br J Radiol 45:944–945

    Article  PubMed  CAS  Google Scholar 

  • Makunura CN, Curling OM, Yeomans P, Perry N, Wells CA (1994) Apocrine adenosis within a radial scar: a case of false positive breast cytodiagnosis. Cytopathol 5:123–128

    Article  CAS  Google Scholar 

  • McDivitt RW, Stewart FW, Berg JW (1968) Relatively rare carcinomas. In: Tumours of the breast. Atlas of tumour pathology, 2nd series, Fascicle 2. Armed Forces Institute of Pathology, Washington DC, p 91

    Google Scholar 

  • Mitnick JS, Vazquez MF, Harris MN, Roses DF (1989) Differentiation of radial scar from scirrhous carcinoma of the breast: mammographic-pathologic correlation. Radiology 173:697–700

    PubMed  CAS  Google Scholar 

  • Nielsen BB (1987) Adenosis tumour of the breast — a clinicopathological investigation of 27 cases. Histopathology 11:1259–1275

    Article  PubMed  CAS  Google Scholar 

  • Nielsen M, Jensen J, Andersen JA (1985) An autopsy study of radial scar in the female breast. Histopathology 9:287–295

    Article  PubMed  CAS  Google Scholar 

  • Nielsen M, Christensen L, Andersen J (1987) Radial scars in women with breast cancer. Cancer 59:1019–1025

    Article  PubMed  CAS  Google Scholar 

  • Nielsen NS, Nielsen BB (1986) Mammographic features of sclerosing adenosis presenting as a tumour. Clin Radiol 37:371–373

    Article  PubMed  CAS  Google Scholar 

  • Oberman HA, Markey BA (1991) Non-invasive carcinoma of the breast presenting in adenosis. Mod Pathol 4:31–35

    PubMed  CAS  Google Scholar 

  • Orel SG, Evers K, Yeh IT, Troupin RH (1992) Radial scar with microcalcifications: radiologic-pathologic correlation. Radiology 183:479–482

    PubMed  CAS  Google Scholar 

  • Page DL, Anderson TJ (1987) Radial scars and complex sclerosing lesions. In: Diagnostic histopathology of the breast. Churchill Livingstone, New York, pp 89–103

    Google Scholar 

  • Page DL, Simpson JF (2001) What is apocrine adenosis anyway? Histopathology 39:433–434

    Article  PubMed  CAS  Google Scholar 

  • Rasbridge SA, Millis RR (1995) Carcinoma in situ involving sclerosing adenosis: a mimic of invasive breast carcinoma. Histopathology 27:269–273

    Article  PubMed  CAS  Google Scholar 

  • Rickert RR, Kalisher L, Hutter RV (1981) Indurative mastopathy: a benign sclerosing lesion of breast with elastosis which may simulate carcinoma. Cancer 47:561–571

    Article  PubMed  CAS  Google Scholar 

  • Rosenblum MK, Purrazzella R, Rosen PP (1986) Is microglandular adenosis a precancerous disease? A study of carcinoma arising therein. Am J Surg Pathol 10:237–245

    Article  PubMed  CAS  Google Scholar 

  • Sabaté JM, Gómez A, Torrubia S, et al. (2002) Microglandular adenosis of the breast in a BRCA1 mutation carrier: radiological features. Eur Radiol 12:1479–1482

    Article  PubMed  Google Scholar 

  • Seidman JD, Ashton M, Lekfkowitz M (1996) Atypical apocrine adenosis of the breast: a clinicopathologic study of 37 patients with 8.7-year follow-up. Cancer 77:2529–2537

    Article  PubMed  CAS  Google Scholar 

  • Selim AG, El-Ayat G, Wells CA (2000) C-erbB2 oncoprotein expression, gene amplification and chromosome 17 aneusomy in apocrine adenosis of the breast. J Pathol 191:138–142

    Article  PubMed  CAS  Google Scholar 

  • Selim AG, El-Ayat G, Naase M, Wells CA (2002) C-myc oncoprotein expression and gene amplification in apocrine metaplasia and apocrine change within sclerosing adenosis of the breast. The Breast 11:466–472

    Article  PubMed  Google Scholar 

  • Selim AG, Ryan A, El-Ayat GA, Wells CA (2001) Loss of heterozygosity and allelic imbalance in apocrine adenosis of the breast. Cancer Detect Prev 25:262–267

    PubMed  CAS  Google Scholar 

  • Simpson JF, Page DL, Dupont WD (1990) Apocrine adenosis — a mimic of mammary carcinoma. Surg Pathol 3:289–299

    Google Scholar 

  • Sloane JP, Mayers MM (1993) Carcinoma and atypical hyperplasia in radial scars and complex sclerosing lesions: importance of lesion size and patient age. Histopathology 23:225–231

    Article  PubMed  CAS  Google Scholar 

  • Tabár L, Dean PB (1985) Stellate lesions. In: Teaching atlas of mammography 1985, 2nd edn. Thieme, Stuttgart, p 89

    Google Scholar 

  • Tanaka Y, Oota K (1970) A stereomicroscopic study of the mastopathic human breast. I. Three-dimensional structures of abnormal duct evolution and their histologic entity. Virchows Arch Abt A Path Anat 349:195–214

    Article  CAS  Google Scholar 

  • Tavassoli FA, Bratthauer GL (1993) Immunohistochemical profile and differential diagnosis of microglandular adenosis. Mod Pathol 6:318–322

    PubMed  CAS  Google Scholar 

  • Wallis MG, Devakumar R, Hosie KB, James KA, Bishop HM (1993) Complex sclerosing lesions (radial scars) of the breast can be palpable. Clin Radiol 48:319–320

    Article  PubMed  CAS  Google Scholar 

  • Wellings SR, Alpers CE (1984) Subgross pathologic features and incidence of radial scars in the breast. Hum Pathol 15:475–479

    Article  PubMed  CAS  Google Scholar 

  • Wellings SR, Jensen HM, Marcum RG (1975) An atlas of subgross pathology of the human breast with special reference to possible precancerous lesions. J Natl Cancer Inst 55:231–273

    PubMed  CAS  Google Scholar 

  • Wells CA, McGregor IL, Makunura CN, Yeomans P, Davies JD (1995) Apocrine adenosis: a precursor of aggressive breast cancer? J Clin Pathol 48:737–742

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Princess Elizabeth Hospital, Le Vauquiedor, St. Martin’s, Guernsey, GY4 6UU, Channel Islands/UK

    Catherine N. Chinyama MB ChB (Hons), MRC Path (Consultant Pathologist)

Authors
  1. Catherine N. Chinyama MB ChB (Hons), MRC Path
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

Copyright information

© 2004 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Chinyama, C.N. (2004). Infiltrative Pseudo-malignant Lesions. In: Benign Breast Diseases. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-18527-4_5

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-18527-4_5

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-62146-8

  • Online ISBN: 978-3-642-18527-4

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation