Radial scar, complex sclerosing lesion and risk of breast cancer. Analysis of 175 cases in Northern Ireland

Background Controversy exists over the nomenclature and clinical significance of radial scar/complex sclerosing lesion (RS/CSL) of the breast. A retrospective analysis of cases diagnosed from 1988 to 2001 in Northern Ireland was performed to determine if any clinical difference exists between the diagnoses of radial scar and complex sclerosing lesion, and establish if lesions suggestive of RS/CSL require excision and/or follow-up. Patients Patients with a diagnosis of RS/CSL from 1988 to 2001 were identified from the databases of the pathology laboratories serving specialist breast surgical units and the Northern Ireland Breast Screening Programme. Results True RS/CSL was confirmed in 175 of 230 cases. There was no difference between RS and CSL regarding associated pathology in the specimen. 16.9% of cases identified at symptomatic clinics were associated with carcinoma in situ, and 15.7% with invasive breast carcinoma, compared to 4.7 and 2.3%, respectively in the screen detected group. One later carcinoma was found. Conclusions There is no clinical difference between the entities radial scar and complex sclerosing lesion. RS/CSL require excision due to their association with malignancy. In the absence of any independent risk factor for carcinoma no further follow-up of patients with RS/CSL is required.