Radial Scar Should Be Removed to Avoid Malignancy Doubt
Study finds percutaneous biopsy may miss malignancies associated with radial scar
THURSDAY, March 25 (HealthDay News) -- The detection of radial scars in percutaneous biopsy does not rule out an associated malignancy, and the scars should be surgically excised to erase doubt, according to a study in the April issue of the American Journal of Roentgenology.
Anna Linda, M.D., of the University of Udine in Italy, and colleagues analyzed medical records in 4,458 imaging-guided percutaneous biopsies, including surgical excision results in 62 cases in which radial scar was the highest-risk lesion found in percutaneous biopsy. The mammographic and sonographic images and surgical findings were reviewed and the underestimation rate for malignancy using percutaneous biopsy was calculated. Mammographic and sonographic appearances of radial scars also were evaluated for their usefulness in differentiating those with and without associated malignancy.
Overall, percutaneous biopsy underestimated malignancy 8 percent of the time (9 percent for sonography-guided biopsies and 5 percent for stereotactically-guided biopsies). Further, there were no sufficient differences between the mammographic and sonographic appearances of the radial scars with and without associated malignancy to distinguish between them.
"A percutaneous diagnosis of a radial scar does not exclude associated malignancy at surgical excision. Mammographic and sonographic features of a lesion diagnosed as a radial scar at percutaneous imaging-guided biopsy do not predict which lesions will have associated malignancy at surgery. Therefore, all patients with percutaneous diagnosis of a radial scar should undergo surgical excision regardless of mammographic and sonographic appearances, until further criteria can be determined," the authors write.