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Radial scar

Case contributed by Henry Knipe
Diagnosis certain

Presentation

Routine screening. Round 2.

Patient Data

Age: 56
Gender: Female
mammography

Architectural distortion upper inner right breast (best seen on CC). 

mammography

Persistent architectural distortion on mag views. 

ultrasound

At 2 o'clock 2 cm from the nipple is a small hypoechoic mass, correlates with mammographic abnormality. 

The patient proceeded to ultrasound guided core biopsy. 

MACROSCOPIC DESCRIPTION: "Right breast Bx 2 oc 2cm FN": Three yellow cream fibrofatty core measuring 8mm each. A1. 

MICROSCOPIC DESCRIPTION: Sections show multiple cores of benign breast parenchyma which shows a markedly fibrotic stroma. There are dilated ductular structures which are lined by bland epithelial cells. There are occasionally slightly irregular ductular structures seen. No evidence of in-situ or invasive malignancy is present. There is a single duct with mild epithelial hyperplasia.

DIAGNOSIS: Right breast Bx 2 o'clock 2cm FN: Benign breast parenchyma with focal microcystic change and mild epithelial hyperplasia without atypia.

COMMENT: No evidence of malignancy is seen. The fibrotic stroma with occasionally irregularly dilated ducts may represent the edge of a radial scar however excision biopsy for definitive assessment may be indicated.

Case Discussion

Patient went on to excisional biopsy, which confirmed the diagnosis of a radial scar. 

Case courtesy of Dr Arlene Mou. 

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