ASSESSMENT OF THE ROLE OF ULTRASOUND IN THE DIFFERENTIATION OF RADIALSCARS AND STELLATE CARCINOMAS OF THE BREAST

Radial scars are benign lesions of the breast which cannot be reliably distinguished from carcinoma by their mammographic appearances alone [1,2]. The present wisdom is that all such lesions should be biopsied [2]. We report a retrospective study carried out to assess whether the re are any ultrasound imaging features that may be useful in different iating radial scars from carcinoma and so reduce the need for excision biopsy. Over a period of 44 months between 1988 and 1992, 530 patient s under,vent surgery for abnormalities detected by routine mammographi c screening. Of the 191 benign lesions excised, 24 were radial scars. Ultrasound images of 21 radial scars were mixed with an equal number o f images of histologically proven carcinomas that had similar mammogra phic appearances. These images were reviewed 'blind' by a single radio logist. We were unable to find any ultrasound appearances sufficiently specific to radial scars to allow confident exclusion of malignancy. We therefore endorse the current practice of biopsying all mammographi cally detected stellate lesions.