Radial Scar at Image-guided Needle Biopsy: Is Excision Necessary? Review uri icon

Overview

abstract

  • Optimal management of a lesion yielding radial scar (RS) without epithelial atypia on breast biopsy is controversial. In this single-institution study spanning 17 years, 53 patients with this biopsy diagnosis were evaluated in terms of clinical, radiologic, and pathologic features and outcomes. RSs were categorized as either "incidental" or as the "targeted" lesion according to defined criteria. Of 48 patients who underwent surgical excision after a diagnosis of RS on biopsy, only 1 had an "upgrade" diagnosis of malignancy (2%). No "incidental" RS was associated with the presence of malignancy on surgical excision. Meta-analysis of 20 RS excision studies demonstrated an overall upgrade rate of 10.4%, with a higher rate in patients with a diagnosis of RS with atypia (26%). The upgrade rate for RS without atypia was 7.5% overall. The lower rate of upgrade to malignancy in this study (2%) is likely related to the thorough radiologic-pathologic review undertaken. In the setting of multidisciplinary agreement and careful radiologic-pathologic correlation, it may be appropriate for patients with a biopsy diagnosis of RS without atypia to forego surgical excision in favor of imaging follow-up.

publication date

  • June 1, 2015

Research

keywords

  • Breast Diseases

Identity

PubMed Central ID

  • PMC5012304

Scopus Document Identifier

  • 84929956294

Digital Object Identifier (DOI)

  • 10.1097/PAS.0000000000000393

PubMed ID

  • 25634748

Additional Document Info

volume

  • 39

issue

  • 6