Radial scar

mfox

I was just diagnosed with a radial scar. I had a mammogram, ultrasound and biopsy all in the same day. My report was benign and now scheduled for surgery. The last week has been a whirlwind and my mind is on overload. I am not worried about the surgery; I am worried about the findings and the 2 week waiting period. I am scared and not sure how to get all the negative thoughts out of my head.

beach2beach

Hi Mfox,

Sorry you find yourself here. So as odd as this will sound, I hope this helps. At my routine mammo/sono, mammo was clean. Sono showed 2 areas next to each other on left and one in right. Radiologist looked at right one, then left. Advised to biopsy left. Did that. Came back proliferative changes and a radial scar. Same as you I was advised to see a surgeon. Even though the surgeon said it was such a tiny chance that cancer could be hiding by the radial scar(which she told me sometimes they find that) I thought for sure I had it.

Without going into long story of my breast cancer which was found in my right breast around same time, I can tell you that when I had my mastectomy surgery because of bc on my right, my surgeon said I told you so,,,the left breast where the radial scar was had no cancer.

I was worried from the moment I goggled radial scar, so I understand. I'm keeping fingers crossed that it will be all good also. I'm betting yours is clean also.

leaf

Just because you had your mammogram, ultrasound and biopsy all in the same day does NOT mean that breast cancer in general grows quickly. Except perhaps for the unusual inflammatory breast cancer (you don't have any of the symptoms for inflammatory breast cancer), most breast cancers are thought to grow relatively slowly.

It is thought that most breast cancers take some 5 to 10 years or more to be large enough to be detected by ANY means.

In this study, the authors concluded that there was no worse prognosis for people who spent <12 weeks from cancer diagnosis to first curative surgery. https://www.ncbi.nlm.nih.gov/pubmed/23529782. (Obviously you haven't been diagnosed with breast cancer at this time.)

Waiting several weeks may drive you crazy emotionally, but it probably won't make your prognosis any worse, even IF you are diagnosed with breast cancer.

Wishing you the best outcome.

runor

I was diagnosed with a radial scar. Mine turned out to be cancer. But you need to know that I am in the vast minority, statistically, with that outcome. Most radial scars / complex sclerosing lesions are NOT cancer.

I am confused. If your report came back as benign, why are you having surgery? Is this radial scar being removed for peace of mind - which is totally valid!!

Talley76

Hi there, I am 41. When I was 27 I had a benign tumor removed in my right breast amd a marker was placed and since then several cyst aspirated on the same breast. In 2013 i had a mammogram and they found architectural distortion in the right breast Nd suggested 6 month follow up. I never received follow up mammograms and my doc never scheduled them. I didn't even know i needed 6 month follow up until I read the report today when comparing my 2013 mammogram, jan-2017 mammogram and the mammogram i had done on Monday. On the Jan 2017 mammogram everything was fine and they recommended 1 year mammogram. A few weeks ago i felt a lump on my right breast so primary looked it over and saw my history and ordered a dignostic mammogram. I went monday and after what seemed like a million pictures aand ultrasound they ssid my lump was just fat no biggie, i had a small cyst and they saw architectural distortion in the right breast and suggested 6 month follow up. I asked the radiologist did this have anything to do with my benign tumor being removed because she mentioned scar tissue that should have diminished since my benign biopsy in my 20s. She then said well it hasnt changed since 2013 and because you have extremely dense tissue to do a 6 month follow up then if it hasn't change do biopsy to make sure its not precancer or cancer. I asked if this is scarring from my original and only biopsy in my 20s and it hasnt chamged why wait for 6 months, why not biopsy now since it probably willnot changed. She agreed and ordered the stero biopsy. What i didint get is why 2013 biopsy showed this architectural distortion in the right breast but the han 2017 mammogram didnt and the mammogram this past monday did. Should i be worried that i could have precancer or cancer? Breast cancer runs on my dads side with his sister and her daughter, but not on my moms. I have a hustory of endometriosis and benign uterine polyps starting in my late 20s which made nearly impossible to get pregnant so we did donor egg ivf...im overly worried

bew66

Talley76, I can't give you a definitive answer on why the AD showed up in 2013, but not the 2017 mammogram, but I will share with you what I learned when I researched AD. AD is the third most common way breast cancer manifests. Number one is a mass, number two is microcalcifications. AD is number 3. AD is considered a subtle finding, so depending on the quality of the images, and the skill of the radiologist, it could be missed on a set of images. That is what I think may have happened with your 2017 mammogram.

I had implants removed, and a lift done in 2004. AD did not show up til 2017, but that was the 1st time I had a 3D mammogram, so I'm thinking it was too subtle to see on regular mammogram. I tried to get the radiologist to say the AD was caused by my prior surgery, but he wouldn't and insisted that I needed a biopsy. The US did not correlate with the finding on mammogram, which I found out was a good sign, because if it does correlate with US, it increases the positive predictor value (PPV) to about 50%!! Very scary! AD is not a finding to be dismissed!

Good for you, standing up and requesting biopsy now versus in 6 months. Sending you positive vibes for benign results!

Concerned2018

Hi, I just sent you a private message, but will post publicly the question asking if you could kindly clarify what you meant when you said the surgeon said he or she told you so? Did he believe you had cancer because you had a radial scar or did he believe you did not have cancer in the left breast?

Also, did your surgeons or doctors have any clue what might be the cause of a radial scar? I am desperately searching for current information and all I can find are articles that are five or more years old. Thanks!

Concerned2018

Hello, I know your question was addressed to someone else's post, but I hope you will both allow my intrusion and allow me to join the conversation. I think I could answer the question as well, although I suppose everybody's situation could be different. I was told I had architectural distortion eight months ago, and I tried to get a second opinion before having a biopsy, and Memorial Sloan let me down (understatement) because they failed to read the scans I brought to them, and the breast surgeon couldn't read scans (yes, this shocked me) & she deferred to the radiologist who failed miserably at her job… I tried for eight months to get answers as to what they saw in my various scans and to see if they agreed I needed a biopsy, but I had wrongly assumed no news was good news when in fact no news meant that the radiologist from Sloan didn't have the expertise and or technology to open the 3-D tomo mammo scams I brought :-(( , & she lacked the humanity to be upfront and honest. In fact, after eight months I didn't even get a single call back from either the surgeon or the radiologist… (yes, of course I called the office multiple times but never received one answer) & I am being completely serious and was close to going with a malpractice suit, but decided to focus on my health instead and seek another opinion and ended up going elsewhere for another mammo. First, I had an MRI that came back negative, but when I went for the mammo… even though the script was for bilateral, the radiologist insisted on only doing the left.

Long story short, they said the architectural distortion looked like it might've even gotten worse and recommended the biopsy, so I did it. One radiologist thought she saw a "vague mass" on the ultrasound when she targeted the same spot, but a breast surgeon I saw after did not agree that there was a mass at all and indeed the first radiologist's report called it a "vague mass" (What the heck is a vague mass… I still don't know?)...but I digress.

Point is that it seems the biopsy of 20 pieces (is that a lot of fragments??) ... the pathology report came back and called it "questionable", but the radiologist on the phone (not the one that did the biopsy, but her colleague) told me it was a benign finding of "radial scar" and at first I was relieved and even told my aging parents, but the next day I was to told by my radiologist that she was advising surgery and that I shouldn't delay it. :-(( This was just this past Tuesday. So, I am super confused and looked to the Internet for answers. If my understanding is correct, it seems that my pathology showed it to be a radial scar, but that while the samples were I believe benign, as some of you have noted, there is about a 10 percent or so chance of there being a hidden cancer. At least this is my understanding? So to answer your question, even though multiple biopsy samples come back benig, it seems doctors want to play it safe and still do surgery to remove the entire scar and I guess some perimeter around it? However, this is only what I am surmising as I'm not getting straight answers from my doctors. I found one article online that expresses exactly what I'm going through, but this article was from 2009 and I am desperate to know if there's been any strides in knowledge or research since then. I posted the link elsewhere, but I'll try to post again.

http://www.telegraph.co.uk/news/health/5297503/Radial-Scar-How-worried-should-we-be-about-this-rare-breast-abnormality.html

runor

Concerned, I don't know if this helps at all ... but it is my understanding that with radial scars, core needle biopsies give notoriously poor results. Radial scars seem to have a different growth pattern that a 'typical' (if there is such a thing) tumour and they just don't give really solid, clear samples using a needle biopsy method.

When my mamm and ultrasound BOTH said I had a radial scar, and mine was relatively large at over 2 cm since most radial scars are found when they are very small, or found by accident. I researched and read over and over that needle biopsy was just not very accurate with radial scar so I opted to skip the needle biopsy and went right to surgical biopsy so there would be no guessing if they got a good sample or enough of a sample.

Mine was cancer. Having made a big slice through the middle of it they were able to determine where they had to go to get the rest of it.

Perhaps your needle biopsy results are just not giving them enough information to make a solid decision and so having it removed entirely (lumpectomy) or a surgical biopsy will settle the confusion once and for all. That is all I can think is going on. I hope it gets sorted out. Worrying is hell.

marie5890

Runor,

I am confused. Did your mammo and US show a radial scar OR surgical scarring???? Two very different things

Infact, I have never known any one to have been told that they have a radial scar based on imaging. If anything, they think it's most likely cancer right off the bat, until pathology shows it to be a radial scar.

Concerned,

Do you have an actual copy of your pathology report ? If so, please post it. It would make it easier for us to help you to know what it actually says, rather than having you tell us what the radiologist said. Thanks

Normal protocol is to remove radial scars. Infact, in all the years I have been here, with only a handful of women coming back with radial scars and not cancer, all of them had these lesions removed.

None were never diagnosed with cancer.

runor

Marie, my mammogram, this being the diagnostic mamm taken after the initial screening mammogram reads:

"...Persistent area of architectural distortion upper-outer quadrant left breast with hypodense central area raising the possibility that this may represent radial scar / complex sclerosing lesion, although malignancy cannot be excluded. This lesion will require a biopsy for definitive diagnosis. Stereotactic biopsy could be performed although this can underestimate pathology in situations of radial scar and fine wire localization with surgical excision could also be considered..."

I had the wire guided surgical excision followed later with lumpectomy. The words surgical scarring never made it into any reports at all. I had had, at that point, no breast surgery.

Ceci-246

Hi mfox,

3 1/2 weeks ago I had a BMX due to multiple concerns in right breast (LCIS, ALH, radial scar). The big news is that they did not contain or hide invasive cancer. What I have read is that many docs want these benign conditions removed as they may hide malignancy, or develop into cancer in a small percentage of cases. My BMX pathology report unexpectedly also showed radial scar in the left breast. So, the BMX removed 4 abnormalities in both breasts. I am so relieved that I am not likely to ever get breast cancer.

From where I sit today, the BMX was less stressful and even less painful than the stereotactic biopsies, because I had appropriate pain meds, great docs, and I believed that I would come out the other side in a better place. The process from mammo to decision to have a BMX was not easy. The not knowing and the constant waiting were just awful. I felt like I would never really know the truth until I removed all breast tissue. Maybe that’s extreme. I only share this to say, I had it in both breasts and it was not cancer. I hope that you, too, will learn that the radial scar is benign.

Best, Ceci