title: Breast cancer risk associated with the diagnosis of a microhistological radial scar (RS): retrospective analysis in 10 years of experience.
abstract: OBJECTIVE
  To retrospectively assess the risk of breast cancer associated with the radial scar (RS) microhistological diagnosis, also taking into consideration the percutaneous biopsy devices used, as well as the different performances of the mammographic systems (analogical, digital and tomosynthesis) in the radiological diagnosis of RS.
  
  
  METHODS
  Between March 2002 and November 2011, 80 RSs were identified using the analogical, digital and tomosynthesis mammographic systems. Based on the microhistological examination, the patients were divided into three groups [RS without hyperplasic-proliferative lesions (HPL); RS with HPL; RS with cancer] and we assessed the risk of cancer associated with RS in the first and second group. We evaluated the mammographic features and the BI-RADS categories assigned to RSs, the biopsy devices used and the differences between the pathological examination and the microhistological diagnosis (p < 0.05).
  
  
  RESULTS
  Based on the microhistological examination, 51/80 patients were included in the first group (9 of them not subjected to surgery), 25/80 in the second group and 4/80 in the third one. At the final histological examination, there were 7/42 (16.7%) cancers in the first group and 8/25 (32%) in the second group. The largest number of microhistological underestimation occurred in the patients who were subjected to core biopsy (15 cases) (p < 0.05). Tomosynthesis improved (p < 0.05) the identification of the RS.
  
  
  CONCLUSIONS
  22.3% of the RSs was associated with cancer. Given that at microhistological examination 16.7% of the RS without HPL was cancer at pathology, the surgical excision is preferred. Tomosynthesis was useful to detect parenchymal distortions.
authors.affiliation: Dipartimento di Diagnostica per Immagini e Radioterapia, S.C. Radiologia Universitaria, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Università di Torino, Via Genova 3, 10126, Turin, Italy, annelis78@libero.it.
authors.forename: Annelis
authors.initials: A
authors.lastname: Dominguez
authors.forename: Manuela
authors.initials: M
authors.lastname: Durando
authors.forename: Giovanna
authors.initials: G
authors.lastname: Mariscotti
authors.forename: Francesca
authors.initials: F
authors.lastname: Angelino
authors.forename: Isabella
authors.initials: I
authors.lastname: Castellano
authors.forename: Laura
authors.initials: L
authors.lastname: Bergamasco
authors.forename: Caterina Chiara
authors.initials: CC
authors.lastname: Bianchi
authors.forename: Paolo
authors.initials: P
authors.lastname: Fonio
authors.forename: Giovanni
authors.initials: G
authors.lastname: Gandini
mesh_terms: D062005:Biopsy, Large-Core Needle; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D002921:Cicatrix / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D006801:Humans; D061705:Image-Guided Biopsy; D008327:Mammography; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D013238:Stereotaxic Techniques