Breast, Radial sclerosing lesion [LMP31252]

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Diagnostic Modality: 
Whole Slide Image
Disease Category: 
Cellular Responses to Stress and Toxic Insults: Adaptation, Injury, and Death
Diagnosis: 
Radial sclerosing lesion
Species: 
Human
Organ System: 
Breast
Gender: 
Female
Age: 
55 years
Diagnosis Code: 
ICD-10: N60.3
Slide Contributor Information
Mrkonjic, M., Mete, O.

Keywords

benign breast lesions, radial scar, radial sclerosing lesion

Clinical History

Breast mass.

Clinical Discussion

Radial sclerosing lesion is a benign proliferative breast disease; however it can present as a breast mass and have spiculated margins on imaging that commonly raise suspicion for an invasive carcinoma. Larger lesions may have central lucency on imaging.

Microscopically, there is a central nidus of collagenized or cellular stroma with entrapped and compressed small glands. Radiating away from the nidus are epithelial components that appear to expand or enlarge. Various proliferative changes can be identified including ductal hyperplasias, sclerosing adenosis and cystic changes. All epithelial components maintain their basal cell layer, which can be exploited immunohistochemically to distinguish it from invasive tubular and ductal carcinomas. Foci of squamous metaplasia may also raise a differential of low grade adenosquamous carcinoma.

Excision is curative and in the absence of atypical epithelial proliferation, the risk of malignancy is similar to proliferative breast disease without atypia. Atypical hyperplasia is associated with larger radial sclerosing lesions (>1 cm) and in older women (>50 years).