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| ==Complex sclerosing lesion== | | ==Complex sclerosing lesion== |
| *[[AKA]] ''radial scar''. | | *[[AKA]] ''radial scar''. |
| ===General===
| | {{Main|Complex sclerosing lesion}} |
| *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>
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| *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>
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| *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>
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| *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>
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| ===Gross===
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| *Spiculated mass.
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| *Usually small - 3-7 mm.
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| ====Image====
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| <gallery>
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| Image:Radial_scar.jpg | Radial scar - gross. (WC)
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| </gallery>
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| ===Microscopic===
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| 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>
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| *Stellate appearance (low magnification).
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| *Center of lesion has "fibroelastosis" - stroma light pink (on H&E) - '''key feature'''.
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| **Scar like stroma with entrapped normal breast ducts and lobules.
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| **Glands appear to enlarge with distance from center of lesion.
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| Notes:
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| *Histomorphologic appearance may mimic a [[desmoplastic reaction]] of the stroma - leading to a misdiagnosis of malignancy.
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| *"[[Hyaline]] - pink stuff on H&E - is the key."
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| DDx:
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| *[[Invasive ductal carcinoma]] - should be considered if the lesion is asymmetrical ''or'' glands are dilated centrally.
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| ====Images====
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| *[http://www.breastpathology.info/Images/Benign/Radial_scar/rs3a_700.jpg Radial scar (breastpathology.info)].
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| ===IHC===
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| Features:
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| *p63 +ve.
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| *Calponin +ve.
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| Note:
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| *HMWK +ve/-ve. (???)
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| =Stromal lesions= | | =Stromal lesions= |