Complex Sclerosing Lesion (Radial Scar)

Epidemiology:

Common sites:

Gross features:

Histologic features:

• stellate
• central nidus of entrapped small tubules in a hyalinized stroma
• surrounding area of radiating arms of epithelium
• cyst formation
• hyperplasia
• often elastosis in centre
• may have components of sclerosing adenosis, papilloma, or epithelial hyperplasia

Immunophenotype:

Marker:

Sensitivity:

Specificity:

Molecular features:

Other features:

• may be mistaken grossly and radiologically for irregular invasive carcinoma
• not a true scar (not associated with history of trauma or surgery)
• associated with a 2x increased risk of subsequent breast CA (bilateral)
• small risk of CA on subsequent lumpectomy
• recommended lumpectomy if radial scar on needle core

References:

• Jacobs TW, Connolly JL, Schnitt SJ. Nonmalignant lesions in breast core needle biopsies: to excise or not to excise? Am J Surg Pathol. 2002;26(9):1095-110.