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Magnetic Resonance Imaging Assessment of Radial Scars/complex Sclerosing Lesions of the Breast

Author(s):

Xavier Bargallo*, Belen Ubeda, Sergi Ganau, Blanca Gonzalez, Miguel Macedo, Inma Alonso, Gabriela Oses, Maria Vidal and Gorane Santamaria   Pages 1 - 7 ( 7 )

Abstract:


Purpose: To describe the magnetic resonance characteristics of radial scars/complex sclerosing lesions (RS/CSL) of the breast using the current BI-RADS lexicon. To investigate the value of diffusion weighted imaging to predict malignancy.

Patients and Methods: From 2010 to 2017, we have found 25 women with architectural distortion at mammography who underwent surgical resection with a final hystopathologic report of RS/CSL. For the description of MRI findings, we adhered to BI-RADS classification (5th edition).

Results: The final pathological diagnosis was: “pure” RS/CSL in 7 cases (28%), RS/CSL with associated high risk lesions in 12 (48%) and 6 cases (24%) were associated with malignancy.

Magnetic resonance findings: four of 25 negative or focus. Five of 25 mass enhancement: irregular, non circumscribed spiculated mass with heterogeneous or rim enhancement and most with type II curves. Sixteen of 25 non mass enhancement: focal or linear distribution and heterogeneous internal enhancement most with type I curves. Six of 25 had cancer associated with the complex sclerosing lesion. All six showed non-mass enhancement.

Two cases with invasive breast carcinoma had ADC values under 1.15 x10−3 mm/s while most of the rest had the values above.

Conclusion: Most RS/CSL showed enhancement at MR. The predominant pattern was a non-mass, focal, heterogeneous internal enhancement with type 1 curves. All cases with associated cancer showed non mass enhancement. Invasive breast cancers had ADC values < 1.15 10-3 s/mm2.

Keywords:

Radial scar, complex sclerosing lesion, breast cancer, magnetic resonance imaging.

Affiliation:

Hospital Clinic de Barcelona, Department of Radiology (CDIC), Barcelona, Hospital Clinic de Barcelona, Department of Radiology (CDIC), Barcelona, Hospital Clinic de Barcelona, Department of Radiology (CDIC), Barcelona, Hospital Clinic de Barcelona, Department of Pathology (CDIC), Barcelona, Hospital Clinic de Barcelona, Department of Radiology (CDIC), Barcelona, Hospital Clinic de Barcelona, Department of Gynecology (CDIC), Barcelona, Hospital Clinic de Barcelona, Department of Radiation Oncology (CDIC), Barcelona, Hospital Clinic de Barcelona, Department of Oncology (CDIC), Barcelona, Hospital Clinic de Barcelona, Department of Radiology (CDIC), Barcelona



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