Radial scar at image-guided needle biopsy: Is excision necessary? Journal Article


Authors: Conlon, N.; D'arcy, C.; Kaplan, J. B.; Bowser, Z. L.; Cordero, A.; Brogi, E.; Corben, A. D.
Article Title: Radial scar at image-guided needle biopsy: Is excision necessary?
Abstract: Optimal management of a lesion yielding radial scar (RS) without epithelial atypia on breast biopsy is controversial. In this single-institution study spanning 17 years, 53 patients with this biopsy diagnosis were evaluated in terms of clinical, radiologic, and pathologic features and outcomes. RSs were categorized as either "incidental" or as the "targeted" lesion according to defined criteria. Of 48 patients who underwent surgical excision after a diagnosis of RS on biopsy, only 1 had an "upgrade" diagnosis of malignancy (2%). No "incidental" RS was associated with the presence of malignancy on surgical excision. Meta-analysis of 20 RS excision studies demonstrated an overall upgrade rate of 10.4%, with a higher rate in patients with a diagnosis of RS with atypia (26%). The upgrade rate for RS without atypia was 7.5% overall. The lower rate of upgrade to malignancy in this study (2%) is likely related to the thorough radiologic-pathologic review undertaken. In the setting of multidisciplinary agreement and careful radiologic-pathologic correlation, it may be appropriate for patients with a biopsy diagnosis of RS without atypia to forego surgical excision in favor of imaging follow-up. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.
Keywords: breast carcinoma; radial scar; high-risk breast lesions
Journal Title: American Journal of Surgical Pathology
Volume: 39
Issue: 6
ISSN: 0147-5185
Publisher: Lippincott Williams & Wilkins  
Date Published: 2015-06-01
Start Page: 779
End Page: 785
Language: English
DOI: 10.1097/pas.0000000000000393
PROVIDER: scopus
PUBMED: 25634748
PMCID: PMC5012304
DOI/URL:
Notes: Export Date: 2 July 2015 -- Source: Scopus
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MSK Authors
  1. Jennifer Kaplan
    27 Kaplan
  2. Adriana Dionigi Corben
    66 Corben
  3. Clare D'arcy
    6 D'arcy
  4. Edi Brogi
    515 Brogi
  5. Zenica Leslie Bowser
    23 Bowser
  6. Niamh Conlon
    28 Conlon
  7. Anibal Rhadames Cordero
    11 Cordero