Radial Scars and Complex Sclerosing Lesions

Radial scars are lesions classically seen on a mammogram as a star shaped structure without a central mass. With increasing use of ultrasound, sometimes these lesions may be seen as a small irregular mass on ultrasound. On core needle biopsy the stellate architecture may be seen as fibrous bands with radiating entrapped ducts and lobules between the fibrous bands. Complex sclerosing lesions are similar to radial scars but essentially larger (greater than 1 cm) or more mass like.

Very occasionally malignant tumours may be associated with radial scars and removal as an open biopsy is usually recommended. Although controversial vacuum biopsy excision with a needle can be considered if the lesion appears benign on imaging.

It’s thought that those diagnosed with a radial scar may have a small increase in risk of developing subsequent breast cancer somewhere around 1.5 to 2 time the normal risk. Annual screening with mammography and ultrasound would seem prudent in these women.