Skip to main content
Erschienen in: Breast Cancer Research and Treatment 3/2020

21.07.2020 | Epidemiology

Radial scars and complex sclerosing lesions on core needle biopsy of the breast: upgrade rates and long-term outcomes

verfasst von: E. M. Quinn, E. Dunne, F. Flanagan, S. Mahon, M. Stokes, M. J. Barry, M. Kell, S. M. Walsh

Erschienen in: Breast Cancer Research and Treatment | Ausgabe 3/2020

Einloggen, um Zugang zu erhalten

Abstract

Purpose

Radial scars and complex sclerosing lesions of the breast are part of a group of “indeterminate” breast lesions, which are excised due to risk of coexistent carcinoma. The aim of this study was to assess rate of upgrade of these lesions to invasive and in situ carcinoma and to quantify the risk of development of subsequent cancer in women diagnosed with these lesions.

Methods

A retrospective review of a prospectively maintained breast screening database was performed. All patients with radial scar identified at either core biopsy or final excision biopsy between January 2006 and July 2012 were identified. Full pathological reports for both core biopsy and final excision biopsy were reviewed. Patient outcomes were followed for a mean of 117.1 months.

Results

Of 451 B3 biopsies performed at our screening unit, 95 (22%) were found to have a radial scar or complex sclerosing lesion (CSL) on core needle biopsy. Within this group, 77 had no atypia on CNB, with 7 (9%) upgraded to invasive/in situ carcinoma on final excision. Of nine with definite atypia on CNB, 3 (33%) were upgraded. In those patients without atypia or malignancy on final excision, 7.5% developed cancer during 10-year follow-up.

Conclusion

Patients with radial scar with atypia have a higher risk of upgrade to malignancy. Further research is needed to identify which patients may safely avoid excision of radial scar. Patients with a diagnosis of radial scar on CNB are at increased subsequent risk of breast cancer and may benefit from additional screening.
Literatur
2.
Zurück zum Zitat Bunting DM, Steel JR, Holgate CS, Watkins RM (2011) Long term follow-up and risk of breast cancer after a radial scar or complex sclerosing lesion has been identified in a benign open breast biopsy. Eur J Surg Oncol 37:709–713CrossRef Bunting DM, Steel JR, Holgate CS, Watkins RM (2011) Long term follow-up and risk of breast cancer after a radial scar or complex sclerosing lesion has been identified in a benign open breast biopsy. Eur J Surg Oncol 37:709–713CrossRef
3.
Zurück zum Zitat Donaldson AR, Sieck L, Booth CN, Calhoun BC (2016) Radial scars diagnosed on breast core biopsy: frequency of atypia and carcinoma on excision and implications for management. Breast 30:201–207CrossRef Donaldson AR, Sieck L, Booth CN, Calhoun BC (2016) Radial scars diagnosed on breast core biopsy: frequency of atypia and carcinoma on excision and implications for management. Breast 30:201–207CrossRef
4.
Zurück zum Zitat Ha SM, Cha JH, Shin HJ et al (2018) Radial scars/complex sclerosing lesions of the breast: radiological and clinicopathologic correlation. BMC Med Imaging 18:39CrossRef Ha SM, Cha JH, Shin HJ et al (2018) Radial scars/complex sclerosing lesions of the breast: radiological and clinicopathologic correlation. BMC Med Imaging 18:39CrossRef
5.
Zurück zum Zitat Kalife ET, Lourenco AP, Baird GL, Wang Y (2016) Clinical and radiologic follow-up study for biopsy diagnosis of radial scar/radial sclerosing lesion without other atypia. Breast J 6:637–644CrossRef Kalife ET, Lourenco AP, Baird GL, Wang Y (2016) Clinical and radiologic follow-up study for biopsy diagnosis of radial scar/radial sclerosing lesion without other atypia. Breast J 6:637–644CrossRef
6.
Zurück zum Zitat Cohen MA, Newell MS (2017) Radial scars of the breast encountered at core biopsy: review of histologic, imaging, and management considerations. AJR 209:1168CrossRef Cohen MA, Newell MS (2017) Radial scars of the breast encountered at core biopsy: review of histologic, imaging, and management considerations. AJR 209:1168CrossRef
7.
Zurück zum Zitat Lv M, Zhu X, Zhong S et al (2014) Radial scars and subsequent breast cancer risk: a meta-analysis. PLoS ONE 9(7):e102503CrossRef Lv M, Zhu X, Zhong S et al (2014) Radial scars and subsequent breast cancer risk: a meta-analysis. PLoS ONE 9(7):e102503CrossRef
8.
Zurück zum Zitat Farshi G, Buckley E (2019) Meta-analysis of upgrade rates in 3163 radial scars excised after needle core biopsy diagnosis. Breast Cancer Res Treat 174:165–177CrossRef Farshi G, Buckley E (2019) Meta-analysis of upgrade rates in 3163 radial scars excised after needle core biopsy diagnosis. Breast Cancer Res Treat 174:165–177CrossRef
9.
Zurück zum Zitat Giuliani M, Rinaldi P, Pella R (2018) A new risk stratification score for the management of ultrasound-detected B3 breast lesions. Breast J 24:965–970CrossRef Giuliani M, Rinaldi P, Pella R (2018) A new risk stratification score for the management of ultrasound-detected B3 breast lesions. Breast J 24:965–970CrossRef
12.
Zurück zum Zitat Aroner SA, Collins LC, Connolly JL (2013) Radial scars and subsequent breast cancer risk: results from the nurses’ health studies. Breast Cancer Res Treat 139:277–285CrossRef Aroner SA, Collins LC, Connolly JL (2013) Radial scars and subsequent breast cancer risk: results from the nurses’ health studies. Breast Cancer Res Treat 139:277–285CrossRef
13.
Zurück zum Zitat Sanders ME, Page DL, Simpson JF (2006) Interdependence of radial scar and proliferative disease with respect to invasive breast carcinoma risk in patients with benign breast biopsies. Cancer 106:1453–1461CrossRef Sanders ME, Page DL, Simpson JF (2006) Interdependence of radial scar and proliferative disease with respect to invasive breast carcinoma risk in patients with benign breast biopsies. Cancer 106:1453–1461CrossRef
14.
Zurück zum Zitat Berg JC, Visscher DW, Vierkant RA et al (2008) Breast cancer risk in women with radial scars in benign breast biopsies. Breast Cancer Res Treat 108:167–174CrossRef Berg JC, Visscher DW, Vierkant RA et al (2008) Breast cancer risk in women with radial scars in benign breast biopsies. Breast Cancer Res Treat 108:167–174CrossRef
15.
Zurück zum Zitat Chou WYY, Veis DJ, Aft R (2018) Radial scar on image-guided breast biopsy: is surgical excision necessary? Breast Cancer Res Treat 170:313–320CrossRef Chou WYY, Veis DJ, Aft R (2018) Radial scar on image-guided breast biopsy: is surgical excision necessary? Breast Cancer Res Treat 170:313–320CrossRef
16.
Zurück zum Zitat McGhan LI, Pocksj BA, Wasif N et al (2012) Atypical ductal hyperplasia on core biopsy: an automatic trigger for excisional biopsy. Ann Surg Oncol 19(10):3264–3269CrossRef McGhan LI, Pocksj BA, Wasif N et al (2012) Atypical ductal hyperplasia on core biopsy: an automatic trigger for excisional biopsy. Ann Surg Oncol 19(10):3264–3269CrossRef
17.
Zurück zum Zitat Elsheikh TM, Silverman JF (2005) Follow-up surgical excision is indicated when breast core needle biopsies show atypical lobular hyperplasia or lobular carcinoma-in-situ: a correlative study of 33 patients with review of the literature. Am J Surg Path 29(5):534–543CrossRef Elsheikh TM, Silverman JF (2005) Follow-up surgical excision is indicated when breast core needle biopsies show atypical lobular hyperplasia or lobular carcinoma-in-situ: a correlative study of 33 patients with review of the literature. Am J Surg Path 29(5):534–543CrossRef
18.
Zurück zum Zitat Sohn V, Arthurs Z, Herbet G et al (2007) Atypical ductal hyperplasia: improved accuracy with the 11-gauge vacuum-assisted versus the 14-gauge core biopsy needle. Ann Surg Oncol 14(9):2497–2501CrossRef Sohn V, Arthurs Z, Herbet G et al (2007) Atypical ductal hyperplasia: improved accuracy with the 11-gauge vacuum-assisted versus the 14-gauge core biopsy needle. Ann Surg Oncol 14(9):2497–2501CrossRef
19.
Zurück zum Zitat Pashayan N, Morris S, Gilbert F et al (2018) Cost-effectiveness and benefit-to hazard ratio of risk-stratified screening for breast cancer. JAMA Oncol 4(11):1504–1510CrossRef Pashayan N, Morris S, Gilbert F et al (2018) Cost-effectiveness and benefit-to hazard ratio of risk-stratified screening for breast cancer. JAMA Oncol 4(11):1504–1510CrossRef
20.
Zurück zum Zitat Terry MB, Liao Y, Whittemore AS, Leoce N et al (2019) 10-year performance of four models of breast cancer risk: a validation study. Lancet Oncol 20(4):504–517CrossRef Terry MB, Liao Y, Whittemore AS, Leoce N et al (2019) 10-year performance of four models of breast cancer risk: a validation study. Lancet Oncol 20(4):504–517CrossRef
21.
Zurück zum Zitat Tyrer J, Duffy SW, Cuzick J (2004) A breast cancer prediction model incorporating familial and personal risk factors. Stat Med 23:1111–1130CrossRef Tyrer J, Duffy SW, Cuzick J (2004) A breast cancer prediction model incorporating familial and personal risk factors. Stat Med 23:1111–1130CrossRef
23.
Zurück zum Zitat Cuzick J, Brentnall A (2016) Models for assessment of breast cancer risk. DI Europe, October 2016:55–56 Cuzick J, Brentnall A (2016) Models for assessment of breast cancer risk. DI Europe, October 2016:55–56
Metadaten
Titel
Radial scars and complex sclerosing lesions on core needle biopsy of the breast: upgrade rates and long-term outcomes
verfasst von
E. M. Quinn
E. Dunne
F. Flanagan
S. Mahon
M. Stokes
M. J. Barry
M. Kell
S. M. Walsh
Publikationsdatum
21.07.2020
Verlag
Springer US
Erschienen in
Breast Cancer Research and Treatment / Ausgabe 3/2020
Print ISSN: 0167-6806
Elektronische ISSN: 1573-7217
DOI
https://doi.org/10.1007/s10549-020-05806-z

Weitere Artikel der Ausgabe 3/2020

Breast Cancer Research and Treatment 3/2020 Zur Ausgabe

Update Onkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.