Radiological Case: Incidental Atypical Sclerosing Papilloma Within a Radial Scar on Digital Breast Tomosynthesis

Susan N. Samreth, MS; Kimberly A. Fitzpatrick, MD; Lauren G. Lebeau, MD; Wendy S. MacKerricher, MD; Marisa H. Borders, MD


Appl Radiol. 2017;46(7):44-47. 

In This Article


Radial scars/complex sclerosing lesions are benign lesions of the breast that pose a diagnostic challenge due to their radiologic resemblance to breast cancer. The most common mammographic appearance is a spiculated area of parenchyma with a "black star" effect and a lack of a central tumor mass. Digital breast tomosynthesis with ultrasound may offer some benefit over traditional mammography in terms of detection of architectural distortion and, thus, radial scars. Although multiple core tissue samples obtained by percutaneous core needle biopsy may improve diagnostic yield and mitigate the need for a subsequent surgical biopsy, the current recommendation for management of most RS found on percutaneous biopsy is surgical excision.