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Eur J Surg Oncol. 2005 Dec;31(10):1125-8. Epub 2005 Jul 15.

All radial scars/complex sclerosing lesions seen on breast screening mammograms should be excised.

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1
Royal Victoria Infirmary, Newcastle upon Tyne NE1 4LP, UK.

Abstract

AIM:

To determine the incidence of pre-malignant and malignant conditions in radial scars identified from screening mammograms in women taking part in the UK NHS breast cancer screening programme.

METHODS:

All women in our screening population from 1988 to 2002 with a radiological diagnosis of radial scar or complex sclerosing lesion confirmed on subsequent histopathology were included in this study. Patients were investigated with fine needle aspiration cytology then localisation biopsy (n=46) or straight to localisation biopsy (n=78). Patients where divided into two groups, one with pure RS/CSL with no associated epithelial features and the second with associated ADH, DCIS or invasive cancer.

RESULTS:

One hundred and twenty-four lesions were confirmed histologically as radial scar or complex sclerosing lesions. The median age was 58 years. Of the 124 patients, 82 were pure RS/CSL. Forty-two had associated epithelial lesions, 22 patients had ADH and 20 patients had either in situ or invasive carcinoma. Where FNA was performed (n=46), mammograms had shown three lesions suspicious of cancer, which were not proven histologically. Mammograms picked up five malignancies out of the nine RS/CSL with associated cancers. Of these, FNA confirmed malignancy in only two patients. Where FNA was not done (n=78), mammogram had read five pure RS/CSL as cancers. It picked up only four cancers in RS lesions with DCIS/Ca out of 11.

CONCLUSION:

All screen-detected stellate lesions should be excised due to their association with pre-malignant and malignant conditions.

PMID:
16024215
DOI:
10.1016/j.ejso.2005.04.004
[Indexed for MEDLINE]
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