What is the differential, and what diagnosis do you favour?
Differential diagnosis of a spiculated breast lesion includes: breast cancer, radial scar, surgical scar and fat necrosis. The lack of central density, pattern of long spicules and the different appearances on the two views favour a radial scar.
There is a spiculated mass in the lateral left breast, which is best seen on the CC projection. On the MLO view, there is some architectural distortion in the upper quadrant but no discrete mass.
On CC, the lesion demonstrates long black spicules "black star" but there is no increase in the density of the central portion of the lesion.