Radial Scar/Complex Sclerosing Lesion

Savitri Krishnamurthy, MD

Key Facts

Clinical Issues

Most radial sclerosing lesions are microscopic findings detected following investigation of mammographically found density lesions
- Risk factor for subsequent development of breast carcinoma
Both in situ and invasive carcinomas can occur in association with radial sclerosing lesions

Cytopathology

Variable cellularity with clusters of benign ductal epithelial cells of varying sizes ± hyperplasia, associated with few naked bipolar nuclei, fragments of elastoid, and fibrocollagenous tissue in background
Cytologic findings are very similar to fibrocystic changes

Top Differential Diagnoses

Tubular carcinoma

(A) Pap-stained FNA smear of a radial scar shows an elastoid stromal fragment

. (B) Pap-stained FNA smear of a radial scar shows small clusters of benign ductal epithelial cells

with associated myoepithelial cells

including a few naked bipolar nuclei in the background

. (C) Pap-stained FNA smear of a radial scar shows a tubular fragment that mimics the neoplastic glands of tubular carcinoma. (D) Pap-stained FNA smear shows a tubular fragment that is composed of benign ductal epithelial cells