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| Case
of the Month |
by
Dr K C Choy AM (Mal), MBBS,
M.Med, FRCR
Answer to Case Of the Month
Discussion
There is a spiculated lesion in the upper outer quadrant in the left MLO
view but not seen on the CC view except in the extended CC view (not shown).
Paddle compression view confirms a stellate lesion. Hook wire localisation
using stereo tactic guidance was followed by surgical excision. Specimen
radiograph confirmed the complete removal of the mammographic abnormality.
Histopathological examination revealed the diagnosis of radial scar.
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| Radial
Scar |
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A radial scar is
seen as a stellate lesion on mammograms. Such a “scar” is not due to
trauma, surgery or inflammation but is a pathologic condition in which
ductal elements are surrounded by bands of fibrous tissue radiating from
a central sclerotic focus. It is also known by such names as radial
sclerosing lesion, sclerosing duct hyperplasia or indurative mastopathy.
Radial scars are benign but are associated with tubular carcinomas.
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On mammograms,
radial scars are spiculated and may have radiolucent centres.
Calcifications when seen are usually of the benign adenosis type.
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Even when findings
are suggestive of radial scar, it is not possible to exclude an invasive
breast carcinoma, which commonly presents as a spiculated mass. Thus,
biopsy is required in such lesions.
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Other conditions
which can present as a spiculated lesion on mammogram include:
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Postsurgical scar
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Fat necrosis
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Sclerosing
adenosis
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| About
the Author |
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Dr K C Choy
is currently attached to the Mahkota Medical
Centre, Melaka as Radiologist.
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Last Updated:
Thursday, 21 August, 2003
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