What is a radial scar?
A radial scar (RS), also known as complex sclerosing lesion (CSL), is a benign (non-cancerous) breast lesion that consists of a central fibroelastic core surrounded by radiating duct-like structures. Radial scars and complex sclerosing lesions are the same but are often referred to as radial scars when they’re smaller than 1 cm in size and CSL when larger than 1 cm.
Despite its name, a radial scar is not a scar, it gets its name from how it appears on a mammogram. These lesions do not typically cause symptoms and is often discovered incidentally during imaging studies or breast biopsies performed for other reasons. However, in some cases, a radial scar may present as a palpable breast lump.
What are symptoms of radial scar/CSL?
Radial scars usually do not cause symptoms on their own. However, if symptoms are present, they may include:
- Palpable Lump: In some instances, a radial scar may be palpable as a breast lump during self-examination or clinical breast examination.
- Breast Changes: Changes in breast texture or appearance, although these are less common.
What causes radial scar/CSL?
The exact cause of radial scar formation is not fully understood, but it is believed to result from changes within the breast ducts and surrounding tissue. Hormonal factors may play a role in the development of radial scars, as they are more commonly found in premenopausal women and may be associated with hormonal fluctuations.
What treatments options are available for radial scar/CSL?
At The Iowa Clinic, our experienced team of healthcare professionals will work with you to develop a personalized treatment plan for radial scar, tailored to your individual needs. Treatment options may include:
- Close Monitoring: In many cases, especially if the radial scar is small and asymptomatic, close monitoring through regular clinical breast exams and imaging studies may be recommended to ensure stability and rule out any underlying concerns.
- Surgical Excision: Surgical removal of the radial scar may be recommended if it is causing bothersome symptoms, if there are concerns about its appearance on imaging studies, or if there is uncertainty about the diagnosis.
- Biopsy: A biopsy may be performed to obtain a tissue sample from the radial scar for further evaluation and confirmation of the diagnosis.
While radial scars/CSL are benign and do not increase the risk of breast cancer, they can sometimes mimic the appearance of breast cancer on imaging studies, leading to diagnostic challenges and unnecessary anxiety for patients. Additionally, the presence of a radial scar may increase the complexity of interpreting mammograms and other breast imaging studies.