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MedPix® Teaching File Case No: 5829

Case Summary: 5829 - || - - || - -
Contributed by: Christopher J Bennett ( National Capital Consortium ) - || - Author Info
Approved by: Claudia E Galbo ( Uniformed Services University ) - || - Author Info
DiagnosisRadial Scar
Dx confirmed by* Not Provided by Author *
DemographicAge: 44 - Gender: woman -
Historya 44 year-old woman who palpated a lump in her left breast.
Exam and Lab* Not Provided by Author *
ImagesDisplay Case Images - Click Here to Display Images
FindingsCraniocaudal, mediolateral, and mediolateral oblique views of the left breast demonstrate an area of architectural distortion in the upper outer quadrant at the 2 o’clock position. There are radiating linear densities without clear demonstration of a central mass.
   Following needle localization and excisional biopsy, the specimen radiograph again demonstrates radiating linear density without mass or calcification.

Differential Diagnosis:
DifferentialDifferential Diagnosis:
1.   Radial scar
2.   Post biopsy changes
3.   Infiltrating carcinoma
4.   Sclerosing adenosis
Treatment and Followupn/a

Disease TopicRadial Scar
Disease DiscussionRadial scar is a pathologic entity that is not associated with trauma or inflammation. It consists of a spoke-wheel arrangement of ductal tissue and fibrotic bands that converge on a central area of sclerosis. However, no mass is present at the center of the architectural distortion. These lesions cannot be reliably distinguished from infiltrative carcinoma and are biopsied. Biopsy demonstrates DCIS in up to 50% of cases; tubular carcinoma, atypical ductal hyperplasia, and lobular neoplasia are also frequently found at biopsy. Mammographic distinction from other speculated densities, such as post biopsy change and sclerosing adenosis, is also difficult.

REFERENCE:
1.   Fieg, S. Breast Masses: Mammographic and Sonographic Evaluation. Radiologic Clinics of North America, Jan. 92. 30(1) 67-91
2.   Cardenosa, G. Breast Imaging Companion, pp 200-201
Reference(s)1.   Fieg, S. Breast Masses: Mammographic and Sonographic Evaluation. Radiologic Clinics of North America, Jan. 92. 30(1) 67-91
2.   Cardenosa, G. Breast Imaging Companion, pp 200-201


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