Sherwell-Cabello S, Maffuz-Aziz A, Domínguez-Reyes C, Peralta-Casillo G, Cavazos-García R, Rodríguez-Cuevas S

Language: Spanish
References: 0
Page: 621-629
PDF size: 370.22 Kb.

ABSTRACT

Objetive: To present our experience at the Instituto de Enfermedades de la Mama, FUCAM in diagnosis and treatment of radial scars and its association with other breast pathologies, specially, breast cancer.
Methods: A retrospective study was performed, in search of all those patients diagnosed and treated of a radial scar at our institute, since January 2006 to December 2015. An analysis of demographic characteristics, clinical and/or radiological presentation, histo-pathological characteristics, and its association with other breast pathologies, especially breast cancer was performed. All patients included in this study had radiologic studies (mammography, ultrasound and tomosynthesis) and histologic diagnosis made at the Institution. The diagnostictherapeutic procedure mainly indicated was the wire-guided excision. Patients without diagnosis made at the Institution, or those who lost follow-up were excluded.
Results: A total of 175 patients were diagnosed with a radial scar at our Institute, 8 of them being bilateral. Mean age of diagnosis was 50.5 years. Most of these patients did not have any clinical manifestation of this entity (93.75%) and were incidentally found in the radiologic images (n=123) or in pathologic reports of breast surgeries for other diseases (n=52). From 123 patients, 57 patients (46.3%) presented pure radial scars, with no association to other pathologies; whereas the remaining had other breast pathologies associated, principally sclerosing adenosis (30.9%); only in 2 patients (1.6%) a Ductal Carcinoma In Situ and in 2 patients (1.6%) with Lobular Carcinoma In Situ were found associated to the radial scar, which means, found between the spicules of the radial scar. Wire-guided excision was performed in 123 patients, except in three patients who had radial scars that occupy almost the entire breast, in whom only percutaneous biopsy was performed and kept in surveillance in the absence of malignant histopathologic indings.
Conclusion: We demonstrate a small association of radial scars to breast cancer of 1.6%. It is proved that radial scars should not be considered as a risk factor for breast cancer, but core needle biopsy does not rule out its presence or the existence of other premalignant lesions, hence, surgical excision is recommend for diagnosis and treatment. Only in patients with large lesions who would have breast deformity after surgical excision, multiple percutaneous biopsies and close surveillance could be carried out.