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Radial Scar at Image-guided Needle Biopsy: Is Excision Necessary?
Am J Surg Pathol. 2015 Jun; 39(6):779-85.AJ

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.

Authors+Show Affiliations

Departments of *Pathology †Radiology, Memorial Sloan Kettering Cancer Center, New York, NY.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Meta-Analysis

Language

eng

PubMed ID

25634748

Citation

Conlon, Niamh, et al. "Radial Scar at Image-guided Needle Biopsy: Is Excision Necessary?" The American Journal of Surgical Pathology, vol. 39, no. 6, 2015, pp. 779-85.
Conlon N, D'Arcy C, Kaplan JB, et al. Radial Scar at Image-guided Needle Biopsy: Is Excision Necessary? Am J Surg Pathol. 2015;39(6):779-85.
Conlon, N., D'Arcy, C., Kaplan, J. B., Bowser, Z. L., Cordero, A., Brogi, E., & Corben, A. D. (2015). Radial Scar at Image-guided Needle Biopsy: Is Excision Necessary? The American Journal of Surgical Pathology, 39(6), 779-85. https://doi.org/10.1097/PAS.0000000000000393
Conlon N, et al. Radial Scar at Image-guided Needle Biopsy: Is Excision Necessary. Am J Surg Pathol. 2015;39(6):779-85. PubMed PMID: 25634748.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Radial Scar at Image-guided Needle Biopsy: Is Excision Necessary? AU - Conlon,Niamh, AU - D'Arcy,Clare, AU - Kaplan,Jennifer B, AU - Bowser,Zenica L, AU - Cordero,Anibal, AU - Brogi,Edi, AU - Corben,Adriana D, PY - 2015/1/31/entrez PY - 2015/1/31/pubmed PY - 2015/9/1/medline SP - 779 EP - 85 JF - The American journal of surgical pathology JO - Am J Surg Pathol VL - 39 IS - 6 N2 - 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. SN - 1532-0979 UR - https://www.unboundmedicine.com/medline/citation/25634748/Radial_Scar_at_Image_guided_Needle_Biopsy:_Is_Excision_Necessary L2 - https://doi.org/10.1097/PAS.0000000000000393 DB - PRIME DP - Unbound Medicine ER -