Difference between revisions of "Complex sclerosing lesion"
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'''Complex sclerosing lesion''', also '''radial scar''', is a benign [[breast pathology|lesion of the breast]] that is associated with an increased risk of malignancy. | |||
==General== | |||
*The term ''radial scar'' is a misnomer. It isn't a ''scar''. It isn't associated with prior trauma or surgery.<ref name=Ref_PBoD8_1072>{{Ref PBoD8|1072}}</ref> | |||
*May appear malignant on imaging.<ref name=pmid11167596>{{cite journal |author=Ung OA, Lee WB, Greenberg ML, Bilous M |title=Complex sclerosing lesion: the lesion is complex, the management is straightforward |journal=ANZ J Surg |volume=71 |issue=1 |pages=35–40 |year=2001 |month=January |pmid=11167596 |doi= |url=}}</ref> | |||
*Associated with subsequent elevated risk of breast cancer.<ref>URL: [http://www.cancer.org/docroot/NWS/content/NWS_1_1x_Radial_Scars.asp http://www.cancer.org/docroot/NWS/content/NWS_1_1x_Radial_Scars.asp]. Accessed on: 4 May 2010.</ref> | |||
*Management - usu. surgical excision.<ref name=pmid14514771>{{cite journal |author=Kennedy M, Masterson AV, Kerin M, Flanagan F |title=Pathology and clinical relevance of radial scars: a review |journal=J. Clin. Pathol. |volume=56 |issue=10 |pages=721–4 |year=2003 |month=October |pmid=14514771 |pmc=1770086 |doi= |url=}}</ref> | |||
==Gross== | |||
*Spiculated mass. | |||
*Usually small - 3-7 mm. | |||
===Image=== | |||
<gallery> | |||
Image:Radial_scar.jpg | Radial scar - gross. (WC) | |||
</gallery> | |||
==Microscopic== | |||
Features:<ref name=pmid14514771>{{cite journal |author=Kennedy M, Masterson AV, Kerin M, Flanagan F |title=Pathology and clinical relevance of radial scars: a review |journal=J. Clin. Pathol. |volume=56 |issue=10 |pages=721–4 |year=2003 |month=October |pmid=14514771 |pmc=1770086 |doi= |url=}}</ref><ref name=Ref_BP91>{{Ref BP|91}}</ref> | |||
*Stellate appearance (low magnification). | |||
*Center of lesion has "fibroelastosis" - stroma light pink (on H&E) - '''key feature'''. | |||
**Scar like stroma with entrapped normal breast ducts and lobules. | |||
**Glands appear to enlarge with distance from center of lesion. | |||
Notes: | |||
*Histomorphologic appearance may mimic a [[desmoplastic reaction]] of the stroma - leading to a misdiagnosis of malignancy. | |||
*"[[Hyaline]] - pink stuff on H&E - is the key." | |||
DDx: | |||
*[[Invasive ductal carcinoma]] - should be considered if the lesion is asymmetrical ''or'' glands are dilated centrally. | |||
===Images=== | |||
*[http://www.breastpathology.info/Images/Benign/Radial_scar/rs3a_700.jpg Radial scar (breastpathology.info)]. | |||
==IHC== | |||
Features: | |||
*p63 +ve. | |||
*Calponin +ve. | |||
Note: | |||
*HMWK +ve/-ve. (???) | |||
==See also== | |||
*[[Breast pathology]]. | |||
==References== | |||
{{Reflist|2}} | |||
[[Category:Diagnosis]] | [[Category:Diagnosis]] | ||
[[Category:Breast_pathology]] |