An Overview of Radial Scars and Breast Cancer Risk

A radial scar is a star-shaped breast mass that may be completely benign, or it may be precancerous or contain a mixture of tissue, including hyperplasia, atypia, or cancer.

If a radial scar is rather large, it may appear on a regular screening mammogram. It can look like an irregularly shaped star, having spiked arms radiating away from the center.

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

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, a radial scar may cause some breast pain.

Because they don't cause many symptoms, radial scars are most often discovered during a biopsy for another purpose.

An estimated 0.04 percent of women, or six out of every 15,000, are diagnosed annually with a radial scar of the breast. Women between the ages of 41 and 60 are at the highest risk for a radial scar.

While "scar" is in the name, a radial scar is not always made of scar tissue. It's called that because it has a scar-like appearance on an x-ray.

A radial scar may be caused by breast surgery, breast inflammation, or hormonal changes. It may also be the byproduct of fibrocystic changes in the breast that normally occur as you age.

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

• Mammogram
• Ultrasound
• MRI with contrast
• Core needle biopsy

You may not need all of these tests, but it is important to have a breast biopsy so a pathologist can examine the tissue. Studies have found that mammography and ultrasound alone can't exclude the presence of cancerous tissue in a radial scar, and therefore a biopsy of some form will be needed for anyone with a radial scar until better diagnostic techniques are developed.

Significance of a Diagnosis

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

You have a few options for radial scar treatment. Many doctors advise patients to have this breast mass surgically removed in order to prevent a possible malignancy from forming. This may be done with an open surgical biopsy or a lumpectomy, depending on the size of the radial scar. The tissue from your surgery will be examined and tested in a lab.

If your radial scar did not contain any invasive breast cancer cells, you won't need radiation, chemotherapy, or hormonal therapy as follow-up treatments.

If you do have an increased risk of malignancy, your doctor may suggest being extra vigilant about your breast health.

Keep your risk of breast cancer low by sticking to an anticancer diet and other strategies that reduce breast cancer risk, such as regular exercise, maintaining a healthy weight, and lowering your stress levels. Avoid using alcohol and tobacco to protect your overall health.

A Word From Verywell

It is frightening to know you have a condition that can raise the risk of developing breast cancer. What has helped some people at risk of breast cancer better cope with these odds is knowing that at least you have awareness.

All women are at risk of breast cancer, with the disease happening in one out of eight of us. Those at an increased risk due to a radial scar or a family history are often more likely to follow through with screening tests. In this sense, having a risk factor for breast cancer may at least increase the chance that, if you develop breast cancer, you may find it at an earlier stage than someone who is not as vigilant about screening measures.