Radial Scars and Breast Cancer Risk

A radial scar is a star-shaped breast mass that may be completely benign, precancerous, or contain a mixture of tissue, including hyperplasia, atypia, or cancer. If one is rather large, it may appear on a regular screening mammogram. A radial scar is named as such because it has a center from which ducts stem and because it has the appearance of a scar when examined by a pathologist.

While some may not be cancerous, their presence does increase one's breast cancer risk. Further concerning, the nature of radial scars is not very easy to diagnose.

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.

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 when a sample of the tissue is viewed under a microscope.

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
• Magnetic resonance imaging (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 in question. 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.

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.

Your doctor may order extra screening mammograms to document any breast changes.

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.

Some women choose to go this route—even though 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 doctor will discuss the appropriateness of these options in regard to your specific case with you.

There is nothing you can do to prevent a radial scar. However, because of the increased risk of malignancy that a radial scar carries, 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 following other strategies that reduce breast cancer risk, such as engaging in regular exercise, maintaining a healthy weight, and lowering your stress levels. Avoid using alcohol and tobacco to protect your overall health as well.

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 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.