RADIAL SCARS OF THE BREAST - REVIEW OF 38 CONSECUTIVE MAMMOGRAPHIC DIAGNOSES

The authors report 38 consecutive cases of histologically proved breas t radial scars (RSs) detected at mammography. In a retrospective revie w of mammograms in 30 matched cases of nonpalpable RS and nonpalpable scirrhous cancer, the characteristic mammographic features of RS were confirmed: (a) the absence of a central opacity, often substituted by a radiolucent area; (b) the presence of multiple elongated thin spicul es radiating from the center of the lesion; (c) the infrequency of any palpable finding, even for superficial lesions of relatively large si ze. Microcalcifications with aspecific structure were found in the les ions on mammograms of 14 of the 38 cases and in 24 of the histologic s pecimens. The typical mammographic features of RS were not specific to RS, being present in a minority of cancer cases. For two blinded read ers, sensitivity was 86.7% and 76.7% and specificity was 78% and 80%, respectively. Although some specific mammographic features may suggest the presence of RS, the final differential diagnosis from scirrhous c ancer should be based on histologic evidence, and surgical biopsy shou ld be advised for any stellate lesion detected at mammography.