Preview

Yakut Medical Journal

Advanced search

Radial scar of the breast as a mask of malignant neoplasms

https://doi.org/10.25789/YMJ.2025.89.21

Abstract

In order to study the radial scar as a mask of malignancy, a literature review was conducted. It was found that the difficulty in diagnosing the radial scar is due to its morphological similarity to a malignancy and associated intraductal epithelial proliferations. To exclude a malignancy and intraductal proliferations, immunohistochemical visualization of the intact myoepithelial cell layer is used, as well as cellular heterogeneity of intraductal proliferations using markers such as p63, basal cytokeratins, smooth muscle actin, basal cytokeratins, and estrogen receptor. It was found that in the case of a combination of a radial scar with atypia or other high-risk lesions of the mammary gland, the likelihood of its transformation into malignant lesions of the mammary gland increases.

About the Authors

N. B. Pilkevich
Белгородский гос. национальн. исслед. ун-т, Медицинский ин-т
Russian Federation


R. R. Khabibullin
Белгородский гос. национальн. исслед. ун-т, Медицинский ин-т
Russian Federation


V. A. Markovskaya
Белгородский гос. национальн. исслед. ун-т, Медицинский ин-т
Russian Federation


O. V. Yavorskaya
Белгородский гос. национальн. исслед. ун-т, Медицинский ин-т
Russian Federation


A. P. Smirnova
Белгородский гос. национальн. исслед. ун-т, Медицинский ин-т
Russian Federation


References

1. Bao JJ., Jaskowiak NT. Clinical management of radial scar without atypia diagnosed on core needle biopsy // Ann Breast Surg 2021; Vol. 5. P. 6. doi: 10.21037/abs-20-85

2. Darras C., Uchida M. Upgrade risk of image-targeted radial scar and complex sclerosing lesions diagnosed at needle-guided biopsy: a retrospective study // Eur Radiol. 2023. Vol. 33. P. 8399-8406. doi:10.1007/s00330-023-09877-6

3. European guidelines for the diagnosis, treatment and follow-up of breast lesions with uncertain malignant potential (B3 lesions) developed jointly by EUSOMA, EUSOBI, ESP (BWG) and ESSO / IT. Rubio [et al.] // European Journal of Surgical Oncology. 2024. Vol. 50. P. 107292 doi: 10.1016/j.ejso.2023.107292

4. Evaluation of Benign Breast Diseases With or Without Atypical Epithelial Hyperplasia Accompanying Radial Scars / Z. Turkyilmaz [et al.] // Eur J Breast Health. 2023. Vol. 19. No 2. P. 166-171. doi: 10.4274/ejbh.galenos.2023.2022-10-4

5. Fenoglio C., Lattes R. Sclerosing papillary proliferations in the female breast. A benign lesion often mistaken for carcinoma. Cancer. 1974. [et al.] // Vol. 33. No 3. P. 691-700. doi: 10.1002/1097-0142(197403)33:3<691::aid-cncr2820330313>3.0.co;2-l.

6. Ferre R., Kuzmiak CM. Radial Scar: What the Radiologist Needs to Know at the End of 2021 // Arch Breast Cancer. 2022. Vol. 9. No. 1. P. 4-9 doi:10.32768/abc.2022914-9

7. First International Consensus Conference on lesions of uncertain malignant potential in the breast (B3 lesions) / CJ. Rageth [et al.] // Breast Cancer Res Treat. 2016. Vol. 159 No 2. P. 203-13. doi: 10.1007/s10549-016-3935-4

8. Hamperl H. Strahlige Narben und obliterierende Mastopathie Beiträge zur pathologischen Histologie der Mamma // Virchows Arch A Pathol Anat Histol. 1975. Vol. 369. No 1. P. 55-68. doi: 10.1007/BF00432461

9. High-risk lesions of the breast: concurrent diagnostic tools and management recommendations / F. Catanzariti [et al.] // Insights Imaging. 2021. Vol. 12. No 1. P. 63. doi: 10.1186/s13244-021-01005-6

10. Lesions of "uncertain malignant potential" in the breast (B3) identified with mammography screening / C. Richter-Ehrenstein [et al.] // BMC Cancer. 2018. Vol. 18. No 1. P. 829. doi: 10.1186/s12885-018-4742-6

11. Malignancy Upgrade Rates of Radial Sclerosing Lesions at Breast Cancer Screening. / P. Yan [et al.] // Radiol Imaging Cancer. 2021. Vol. 3. No 6. P. 210036. doi: 10.1148/rycan.2021210036.

12. Mooney KL., Bassett LW., Apple SK. Upgrade rates of high-risk breast lesions diagnosed on core needle biopsy: a single-institution experience and literature review // Mod Pathol. 2016. Vol. 29. No 12. P. 1471-1484. doi: 10.1038/modpathol.2016.127

13. Outcome of radial scar/complex sclerosing lesion associated with epithelial proliferations with atypia diagnosed on breast core biopsy: results from a multicentric UK-based study / E. Rakha [et al.] // J Clin Pathol. 2019. Vol. 72. No 12. P. 800-804. doi: 10.1136/jclinpath-2019-205764.

14. Outcomes of atypical (B3) core biopsy lesions diagnosed across BreastScreen NSW / R. Chou [et al.] // Australia. Breast. 2024. Vol. 29. No 75. P. 103720. doi: 10.1016/j.breast.2024.103720

15. Positive predictive value for malignancy of uncertain malignant potential (B3) breast lesions diagnosed on vacuum-assisted biopsy (VAB): is surgical excision still recommended? / M. Lucioni [et al.] // Eur Radiol. 2021. Vol. 31. No 2. P. 920-927. doi: 10.1007/s00330-020-07161-5.

16. Radial scars and complex sclerosing lesions on core needle biopsy of the breast: upgrade rates and long-term outcomes / EM. Quinn [et al.] // Breast Cancer Res Treat. 2020. Vol. 183. No 3. P. 677-682. doi: 10.1007/s10549-020-05806-z

17. Radial Scar: a management dilemma / CML. Trombadori [et al.] // Radiol Med. 2021. Vol. 126. No 6. P. 774-785. doi: 10.1007/s11547-021-01344-w

18. Radial Scars and Complex Sclerosing Lesions of the Breast: Prevalence of Malignancy and Natural History Under Active Surveillance / E. Kraft [et al.] // Ann Surg Oncol. 2021. Vol. 28. No 9. P. 5149-5155. doi: 10.1245/s10434-021-09713-5.

19. Radial sclerosing lesions found on core needle biopsy: excision can be safely avoided / A. Grabenstetter [et al.] // Histopathology. 2024. Vol. 85. No 3. P. 397-404. doi: 10.1111/his.15233.

20. Radial Scars Without Atypia Diagnosed at Percutaneous Core Needle Breast Biopsy: Support for Imaging Surveillance / DS. Polat [et al.] // Eur J Breast Health. 2023. Vol. 19. No 1. P. 76-84. doi: 10.4274/ejbh.galenos.2022.2022-9-3

21. Radial scars/complex sclerosing lesions of the breast: radiologic and clinicopathologic correlation / S. Ha [et al.] // BMC Med Imaging. 2018. Vol. 18. P. 39. doi.org/10.1186/s12880-018-0279-z

22. Radial Sclerosing Lesion (Radial Scar): Radiologic-Pathologic Correlation / P. Yan [et al.] // J Breast Imaging. 2024. Vol.6. No 6. P. 646-657. doi: 10.1093/jbi/wbae046

23. Rate of radial scars by core biopsy and upgrading to malignancy or high-risk lesions before and after introduction of digital breast tomosynthesis / A. Phantana-Angkool [et al.] // Breast Cancer Res Treat. 2019. Vol. 173. No 1. P. 23-29. doi: 10.1007/s10549-018-4973-x.

24. Reducing indications for radial scar surgical excision in Slovenian breast cancer screening program / G. Gašljević [et al.] // Ann Diagn Pathol. 2020. Vol. 45. P. 151438. doi: 10.1016/j.anndiagpath.2019.151438.

25. Second International Consensus Conference on lesions of uncertain malignant potential in the breast (B3 lesions) / CJ. Rageth [et al.] // Breast Cancer Res Treat. 2019. Vol. 174. No 2. P. 279-296. doi: 10.1007/s10549-018-05071-1

26. The effect of delay of excisional biopsy on upstage rate for atypical ductal hyperplasia, flat epithelial atypia, intraductal papilloma, and radial scar / J. Casaubon [et al.] // Breast Cancer Res Treat. 2022. Vol. 196. No 3. P. 527-534. doi: 10.1007/s10549-022-06745-7.

27. The positive predictive value of vacuum assisted biopsy (VAB) in predicting final histological diagnosis for breast lesions of uncertain malignancy (B3 lesions): A systematic review & meta-analysis / C. Cullinane [et al.] // Eur J Surg Oncol. 2022. Vol. 48. No 7. P. 1464-1474. doi: 10.1016/j.ejso.2022.04.005.

28. The Upgrade Risk of B3 Lesions to (Pre) Invasive Breast Cancer After Diagnosis on Core Needle or Vacuum Assisted Biopsy. A Belgian National Cohort Study / N. Willers [et al.] // Clin Breast Cancer. 2023. Vol. 23. No 4. P. 273-280. doi: 10.1016/j.clbc.2023.03.006

29. Third International Consensus Conference on lesions of uncertain malignant potential in the breast (B3 lesions) / C. Elfgen [et al.] // Virchows Arch. 2023. Vol. 483. No 1. P. 5-20. doi: 10.1007/s00428-023-03566-x

30. Upgrade rate to malignancy of uncertn malignant potential breast lesions (B3 lesions) diagnosed on vacuum-assisted biopsy (VAB) in screen detected microcalcifications: Analysis of 366 cases from a single institution / S. Bianchi [et al.] // Eur J Radiol. 2024. Vol. 170. P. 111258. doi: 10.1016/j.ejrad.2023.

31. Upstage Rate of Complex Sclerosing Lesions/Radial Scars / VM. Jones [et al.] // Am Surg. 2022. Vol. 88. No 5. P. 964-967. doi: 10.1177/00031348211056282.

32. Upstage rate of radial scar/complex sclerosing lesion identified on core needle biopsy / RQ. Liu [et al.] // Am J Surg. 2021. Vol. 221. No 6. P. 1177-1181. doi: 10.1016/j.amjsurg.2021.03.029.

33. Varga Z, Sinn P, Lebeau A. B3-Läsionen der Mamma: Histologische, klinische und epidemiologische Aspekte : Update [B3 lesions of the breast: histological, clinical, and epidemiological aspects: Update] // Pathologie (Heidelb). 2023. Vol. 44. No 1. P. 5-16. doi: 10.1007/s00292-022-01180-3.


Review

For citations:


Pilkevich N.B., Khabibullin R.R., Markovskaya V.A., Yavorskaya O.V., Smirnova A.P. Radial scar of the breast as a mask of malignant neoplasms. Yakut Medical Journal. 2025;(1):90-93. https://doi.org/10.25789/YMJ.2025.89.21

Views: 153


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 1813-1905 (Print)
ISSN 2312-1017 (Online)