Radial Scars and Breast Cancer Risk

A radial scar is a type of breast mass that can be associated with an increased risk of breast cancer. This mass may be benign or precancerous, and it can contain a mixture of tissue, including hyperplasia (increased number of cells), atypia (change in the cell characteristics), or cancer. A large radial scar may appear on a regular screening mammogram. These growths are named radial scars because they appear like a scar when examined microscopically, and they have ducts stemming from their central area.

A radial scar may also be referred to as:

• A complex sclerosing lesion of the breast
• A "black star"
• Sclerosing papillary proliferation
• Infiltrating epitheliosis
• Indurative mastopathy

Symptoms

Radial scars don't usually cause symptoms. A radial scar in breast tissue usually won't cause a lump that you can feel, nor will it make breast skin dimple or discolor. In some cases, they may cause some breast pain.

Because they don't cause many symptoms, they are most often discovered during a mammogram or a biopsy that's done for another purpose.

Causes

While "scar" is in the name, a radial scar is not necessarily made of scar tissue. It's called that because it has a scar-like appearance when a sample of the tissue is viewed with a microscope.

Diagnosis

If you have a lesion that looks like it could be a radial scar, your healthcare provider will order further studies for evaluation.

Some of the tests used to evaluate a radial scar include:

• Mammogram
• Ultrasound
• Magnetic resonance imaging (MRI) with contrast
• Core needle biopsy

Studies have found that mammography and ultrasound can't exclude the presence of cancerous tissue in a radial scar, and therefore anyone with a radial scar will need to have a biopsy.

A large radial scar can look like breast cancer when it's seen on a mammogram. It's difficult to properly diagnose a radial scar, even with a biopsy, because when viewed with a microscope, the cell geometry closely resembles tubular carcinoma. This typically benign breast mass sometimes has malignant tissue hiding behind it.

If you have had a radial scar, your healthcare provider may order screening mammograms more frequently than what is normally recommended to document any breast changes.

Treatment

The treatment of radial scars remains controversial and the management recommendations depend on the size of the scar, as well as other factors.

In one study, radial scars increased the risk of breast cancer among women with proliferative disease without atypia, but no significant association between radial scars and cancer was noted among women with atypical hyperplasia.

Some women choose to have surgical removal of the mass—even when cancer isn't present. This may be done with an open surgical biopsy or a lumpectomy, depending on the size of the radial scar. The tissue is then examined and tested in a lab.

• If your radial scar does not contain any invasive breast cancer cells, you won't need radiation, chemotherapy, or hormonal therapy as follow-up treatments.
• If the tissue does contain breast cancer cells, your healthcare provider will discuss treatment options with you.

Prevention

There is nothing you can do to prevent a radial scar. If you are diagnosed with this type of mass, your healthcare provider may suggest being extra vigilant about your breast health to reduce your risk of cancer.

Important lifestyle strategies include sticking to an anticancer diet, getting regular exercise, maintaining a healthy weight, and lowering your stress levels. Avoid using alcohol and tobacco to protect your overall health as well.

A Word From Verywell

All women are at risk of breast cancer, with the disease affecting one out of eight females. Those at an increased risk due to a radial scar or a family history may need careful surveillance with regularly scheduled screening tests.