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Radial scars and complex sclerosing lesions on core needle biopsy of the breast: upgrade rates and long-term outcomes.
Breast Cancer Res Treat. 2020 Oct; 183(3):677-682.BC

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.

Authors+Show Affiliations

Department of Surgery, Breastcheck Eccles Unit, Eccles St, Dublin 7, Ireland. edelquinn@rcsi.ie.Department of Surgery, Breastcheck Eccles Unit, Eccles St, Dublin 7, Ireland.Department of Radiology, Breastcheck Eccles Unit, Eccles St, Dublin 7, Ireland.Department of Histopathology, Breastcheck Eccles Unit, Eccles St, Dublin 7, Ireland.Department of Surgery, Breastcheck Eccles Unit, Eccles St, Dublin 7, Ireland.Department of Surgery, Breastcheck Eccles Unit, Eccles St, Dublin 7, Ireland.Department of Surgery, Breastcheck Eccles Unit, Eccles St, Dublin 7, Ireland.Department of Surgery, Breastcheck Eccles Unit, Eccles St, Dublin 7, Ireland.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32696314

Citation

Quinn, E M., et al. "Radial Scars and Complex Sclerosing Lesions On Core Needle Biopsy of the Breast: Upgrade Rates and Long-term Outcomes." Breast Cancer Research and Treatment, vol. 183, no. 3, 2020, pp. 677-682.
Quinn EM, 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. 2020;183(3):677-682.
Quinn, E. M., Dunne, E., Flanagan, F., Mahon, S., Stokes, M., Barry, M. J., Kell, M., & Walsh, S. M. (2020). Radial scars and complex sclerosing lesions on core needle biopsy of the breast: upgrade rates and long-term outcomes. Breast Cancer Research and Treatment, 183(3), 677-682. https://doi.org/10.1007/s10549-020-05806-z
Quinn EM, 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. 2020;183(3):677-682. PubMed PMID: 32696314.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Radial scars and complex sclerosing lesions on core needle biopsy of the breast: upgrade rates and long-term outcomes. AU - Quinn,E M, AU - Dunne,E, AU - Flanagan,F, AU - Mahon,S, AU - Stokes,M, AU - Barry,M J, AU - Kell,M, AU - Walsh,S M, Y1 - 2020/07/21/ PY - 2019/10/14/received PY - 2020/07/11/accepted PY - 2020/7/23/pubmed PY - 2021/6/24/medline PY - 2020/7/23/entrez KW - Breast KW - Breast cancer risk KW - Breast screening KW - Complex sclerosing lesion KW - Radial scar SP - 677 EP - 682 JF - Breast cancer research and treatment JO - Breast Cancer Res Treat VL - 183 IS - 3 N2 - 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. SN - 1573-7217 UR - https://www.unboundmedicine.com/medline/citation/32696314/Radial_scars_and_complex_sclerosing_lesions_on_core_needle_biopsy_of_the_breast:_upgrade_rates_and_long_term_outcomes_ L2 - https://doi.org/10.1007/s10549-020-05806-z DB - PRIME DP - Unbound Medicine ER -