Upstage rate of radial scar/complex sclerosing lesion identified on core needle biopsy

Am J Surg. 2021 Jun;221(6):1177-1181. doi: 10.1016/j.amjsurg.2021.03.029. Epub 2021 Mar 18.

Abstract

Background: We assessed the cancer upstage rate of Radial Scars (RS), and Complex Sclerosing Lesions (CSL), and risk-stratified lesions based on radiological and pathological features.

Methods: Characteristics of RS/CSL treated from 2013 to 2018 were examined for features associated with cancer.

Results: 78 RS/CSL were found on core needle biopsy (CNB) and surgically excised. 9 (11.5%) lesions were upstaged. Upstaged patients were older (66 vs 51, p = 0.033). More upstaged lesions were accompanied by a mass on both mammography (87.5% vs. 30.0%, p = 0.005) and ultrasound (100.0% vs. 62.8%, p = 0.043). 20.5% of lesions biopsied under ultrasound guidance with small needles (14-18G) were upstaged, but no lesions biopsied under stereotactic guidance with large needles (9-12 G) with vacuum assistance were upstaged (p = 0.009).

Conclusions: Excision of RS/CSL seen on CNB is warranted, especially if the patient is older, the CNB is performed under ultrasound guidance with small needles, or if a mass is present on imaging.

Keywords: Breast cancer; Complex sclerosing lesion; Core needle biopsy; High risk lesion; Radial scar; Surgery.

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Biopsy, Large-Core Needle*
  • Breast Diseases / diagnosis*
  • Breast Diseases / diagnostic imaging
  • Breast Diseases / epidemiology
  • Breast Diseases / pathology
  • Breast Neoplasms / diagnosis*
  • Breast Neoplasms / diagnostic imaging
  • Breast Neoplasms / pathology
  • Cicatrix / diagnosis*
  • Cicatrix / diagnostic imaging
  • Cicatrix / epidemiology
  • Cicatrix / pathology
  • Female
  • Humans
  • Mammography
  • Middle Aged
  • Sclerosis
  • Young Adult