Which findings on magnetic resonance mammography (breast MRI) are characteristic of a radial scar or complex sclerosis lesion?

Updated: Feb 25, 2019
  • Author: Preeti Gupta, MD, FRCR; Chief Editor: Eugene C Lin, MD  more...
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Answer

Answer

These lesions may be associated with tubular carcinoma, other invasive carcinoma, DCIS, LCIS, and ADH. They have variable MRI appearances and can present as an MRI-occult lesion, mass, architectural distortion, or nonmass enhancement. The enhancement characteristics are also variable.

(See the images below.)

This lesion is seen as a stellate, modestly enhanc This lesion is seen as a stellate, modestly enhancing lesion on MRI, without a central mass. Excision biopsy showed only a radial scar, with no evidence of malignancy.
A, Image in a patient with a focal irregular nodul A, Image in a patient with a focal irregular nodule on spot compression mammography. B, MRM of this lesion shows a stellate, irregular, strongly enhancing nodule that is indistinguishable from a malignancy. Results of surgical excision confirmed a radial scar with no evidence of malignancy. Capillary microvascular density measurements in the specimen from this lesion showed a marked increase in capillary density, consistent with neoangiogenesis.

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