CYTOLOGIC FEATURES OF 22 RADIAL SCAR COMPLEX SCLEROSING LESIONS OF THE BREAST, 3 OF WHICH ASSOCIATED WITH CARCINOMA - CLINICAL, MAMMOGRAPHIC, AND HISTOLOGIC CORRELATION

Radial scar/complex sclerosing lesion (RS/CSL) of the breast has becom e more frequently detected with the increasing performance of mammogra phy as a screening test. The clinical, mammographic, and cytologic fea tures of 22 cases of histologically proved breast RS/CSL, 3 of which a ssociated with carcinoma arising at the periphery of the lesion were r eviewed. Clinical examination and mammography did not shaw specific fe atures in differentiating RS/CSL from carcinoma of the breast. Cytolog y of RS/CSL without associated malignant changes was dominated by blan d epithelial clusters and bipolar naked nuclei. Apocrine cells, papill ary clusters, foam cells, and fibrillary elastoid material were also f requently seen. At the cytologic review, only one case of RS with apoc rine adenosis, showing atypical cells, was diagnosed as suspicious. Tw o of the three cases of CSL with associated carcinoma in situ were cyt ologically characterized by the presence of single atypical cells. In the third case, characterized by a small tubular carcinoma near to CSL , fine-needle aspiration cytology revealed few tubular clusters withou t myoepithelial cells. Although cytology of RS/CSL without associated carcinoma does not seem characteristic in most cases a diagnosis of be nignancy can be performed correctly. The application of fine-needle as piration cytology to mammographic lesions with features suggesting RS/ CSL may permit a better planning of these lesions. (C) 1997 Wiley-Liss , Inc.