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Radial Scar, Radial Sclerosing Lesions
Hayley Oligane, DO; Marion E. Scoggins, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            TERMINOLOGY

            • Synonyms

              • Scleroelastotic lesion, sclerosing papillary lesion
            • Definitions

              • Radial scar (RS): Benign proliferative lesion with central fibroelastosis and spiculated appearance radiographically and histologically
              • Complex sclerosing lesion (CSL): RS > 1 cm in size
              • Radial sclerosing lesion (RSL): Refers to both RS & CSL
              • Incidental radial scar: Microscopic, entirely contained within core biopsy specimen as part of biopsy targeted to finding other than distortion or spiculated mass, e.g., adjacent to targeted calcifications

            IMAGING

            • General Features

              • Mammographic Findings

                • Ultrasonographic Findings

                  • MR Findings

                    • Image-Guided Biopsy

                      • Imaging Recommendations

                        DIFFERENTIAL DIAGNOSIS

                          PATHOLOGY

                          • General Features

                            • Gross Pathologic & Surgical Features

                              • Microscopic Features

                                CLINICAL ISSUES

                                • Presentation

                                  • Demographics

                                    • Natural History & Prognosis

                                      • Treatment

                                        DIAGNOSTIC CHECKLIST

                                        • Consider

                                          • Image Interpretation Pearls

                                            • Reporting Tips

                                              Selected References

                                              1. Alshafeiy TI et al: Outcome of architectural distortion detected only at breast tomosynthesis versus 2D mammography. Radiology. 288(1):38-46, 2018
                                              2. Calhoun BC: Core Needle biopsy of the breast: an evaluation of contemporary data. Surg Pathol Clin. 11(1):1-16, 2018
                                              3. Chou WYY et al: Radial scar on image-guided breast biopsy: is surgical excision necessary? Breast Cancer Res Treat. 170(2):313-20, 2018
                                              4. Nakhlis F et al: Complex sclerosing lesions and radial sclerosing lesions on core needle biopsy: low risk of carcinoma on excision in cases with clinical and imaging concordance. Breast J. 24(2):133-8, 2018
                                              5. Speer ME et al: High risk breast lesions identified on MRI-guided vacuum assisted needle biopsy: outcome of surgical excision and imaging follow-up. Br J Radiol. 20180300, 2018
                                              6. Bahl M et al: Pathologic outcomes of architectural distortion on digital 2D versus tomosynthesis mammography. AJR Am J Roentgenol. 209(5):1162-7, 2017
                                              7. Cohen MA and Newell MS: Radial scars of the breast encountered at core biopsy: review of histologic, imaging, and management considerations. AJR Am J Roentgenol. 209(5):1168-77, 2017
                                              8. Ferreira AI et al: Radial scar of the breast: Is it possible to avoid surgery? Eur J Surg Oncol. 43(7):1265-72, 2017
                                              9. Mesa-Quesada J et al: Radial scars without atypia in percutaneous biopsy specimens: can they obviate surgical biopsy? Radiologia. 59(6):523-30, 2017
                                              10. Racz JM et al: Challenging atypical breast lesions including flat epithelial atypia, radial scar, and intraductal papilloma. Ann Surg Oncol. 24(10):2842-7, 2017
                                              11. Donaldson AR et al: Radial scars diagnosed on breast core biopsy: frequency of atypia and carcinoma on excision and implications for management. Breast. 30:201-7, 2016
                                              12. Hou Y et al: Surgical excision outcome after radial scar without atypical proliferative lesion on breast core needle biopsy: a single institutional analysis. Ann Diagn Pathol. 21:35-8, 2016
                                              13. Kalife ET et al: Clinical and radiologic follow-up study for biopsy diagnosis of radial scar/radial sclerosing lesion without other atypia. Breast J. 22(6):637-44, 2016
                                              14. Leong RY et al: Radial scar at percutaneous breast biopsy that does not require surgery. J Am Coll Surg. 223(5):712-6, 2016
                                              15. Li Z et al: Pathologic findings of follow-up surgical excision for radial scar on breast core needle biopsy. Hum Pathol. 48:76-80, 2016
                                              16. Park VY et al: Mammographically occult asymptomatic radial scars/complex sclerosing lesions at ultrasonography-guided core needle biopsy: follow-up can be recommended. Ultrasound Med Biol. 42(10):2367-71, 2016
                                              17. Rageth CJ et al: First International Consensus Conference on lesions of uncertain malignant potential in the breast (B3 lesions). Breast Cancer Res Treat. 159(2):203-13, 2016
                                              18. Matrai C et al: Advocating Nonsurgical management of patients with small, incidental radial scars at the time of needle core biopsy: a study of 77 cases. Arch Pathol Lab Med. 139(9):1137-42, 2015
                                              19. Nassar A et al: Radial scar/complex sclerosing lesions: a clinicopathologic correlation study from a single institution. Ann Diagn Pathol. 19(1):24-8, 2015
                                              20. Miller CL et al: Surgical excision of radial scars diagnosed by core biopsy may help predict future risk of breast cancer. Breast Cancer Res Treat. 145(2):331-8, 2014
                                              21. Bianchi S et al: Radial scar without associated atypical epithelial proliferation on image-guided 14-gauge needle core biopsy: analysis of 49 cases from a single-centre and review of the literature. Breast. 21(2):159-64, 2012
                                              22. Heller SL et al: Imaging features and management of high-risk lesions on contrast-enhanced dynamic breast MRI. AJR Am J Roentgenol. 198(2):249-55, 2012
                                              23. Krishnamurthy S et al: Multidisciplinary considerations in the management of high-risk breast lesions. AJR Am J Roentgenol. 198(2):W132-40, 2012
                                              24. Lee KA et al: Risk of malignancy when microscopic radial scars and microscopic papillomas are found at percutaneous biopsy. AJR Am J Roentgenol. 198(2):W141-5, 2012
                                              25. Linda A et al: Magnetic resonance imaging of radial sclerosing lesions (radial scars) of the breast. Eur J Radiol. 81(11):3201-7, 2012
                                              26. Linda A et al: Nonsurgical management of high-risk lesions diagnosed at core needle biopsy: can malignancy be ruled out safely with breast MRI? AJR Am J Roentgenol. 198(2):272-80, 2012
                                              27. Londero V et al: High-risk breast lesions at imaging-guided needle biopsy: usefulness of MRI for treatment decision. AJR Am J Roentgenol. 199(2):W240-50, 2012
                                              28. Morgan C et al: The radial scar of the breast diagnosed at core needle biopsy. Proc (Bayl Univ Med Cent). 25(1):3-5, 2012
                                              29. Tabar L et al: Teaching Atlas of Mammography. 4th ed. Stuttgart, Germany: Thieme, 2012
                                              30. Crystal P et al: High-risk lesions diagnosed at MRI-guided vacuum-assisted breast biopsy: can underestimation be predicted? Eur Radiol. 21(3):582-9, 2011
                                              31. Osborn G et al: A review of needle core biopsy diagnosed radial scars in the Welsh Breast Screening Programme. Ann R Coll Surg Engl. 93(2):123-6, 2011
                                              32. Rajan S et al: Conservative management of screen-detected radial scars: role of mammotome excision. J Clin Pathol. 64(1):65-8, 2011
                                              33. Resetkova E et al: Management of radial sclerosing lesions of the breast diagnosed using percutaneous vacuum-assisted core needle biopsy: recommendations for excision based on seven years' of experience at a single institution. Breast Cancer Res Treat. 127(2):335-43, 2011
                                              34. Linda A et al: Radial scars without atypia diagnosed at imaging-guided needle biopsy: how often is associated malignancy found at subsequent surgical excision, and do mammography and sonography predict which lesions are malignant? AJR Am J Roentgenol. 194(4):1146-51, 2010
                                              35. Pediconi F et al: Role of breast MR imaging for predicting malignancy of histologically borderline lesions diagnosed at core needle biopsy: prospective evaluation. Radiology. 257(3):653-61, 2010
                                              36. Sohn VY et al: The treatment of radial scars in the modern era--surgical excision is not required. Am Surg. 76(5):522-5, 2010
                                              37. Perfetto F et al: Adjunctive diagnostic value of MRI in the breast radial scar. Radiol Med. 114(5):757-70, 2009
                                              38. Berg JC et al: Breast cancer risk in women with radial scars in benign breast biopsies. Breast Cancer Res Treat. 108(2):167-74, 2008
                                              39. Manfrin E et al: Risk of neoplastic transformation in asymptomatic radial scar. Analysis of 117 cases. Breast Cancer Res Treat. 107(3):371-7, 2008
                                              40. Douglas-Jones AG et al: Radial scar lesions of the breast diagnosed by needle core biopsy: analysis of cases containing occult malignancy. J Clin Pathol. 60(3):295-8, 2007
                                              41. Doyle EM et al: Radial scars/complex sclerosing lesions and malignancy in a screening programme: incidence and histological features revisited. Histopathology. 50(5):607-14, 2007
                                              42. Becker L et al: Management of radial scars found at percutaneous breast biopsy. Can Assoc Radiol J. 57(2):72-8, 2006
                                              43. López-Medina A et al: Radial scars diagnosed at stereotactic core-needle biopsy: surgical biopsy findings. Eur Radiol. 16(8):1803-10, 2006
                                              44. Sanders ME et al: Interdependence of radial scar and proliferative disease with respect to invasive breast carcinoma risk in patients with benign breast biopsies. Cancer. 106(7):1453-61, 2006
                                              45. Pediconi F et al: Radial scars of the breast: contrast-enhanced magnetic resonance mammography appearance. Breast J. 11(1):23-8, 2005
                                              46. Brodie C et al: Fourteen-gauge needle core biopsy of mammographically evident radial scars: is excision necessary? Cancer. 100(3):652-3; author reply 653-4, 2004
                                              47. Cawson JN et al: Fourteen-gauge needle core biopsy of mammographically evident radial scars: is excision necessary? Cancer. 97(2):345-51, 2003
                                              48. Brenner RJ et al: Percutaneous core needle biopsy of radial scars of the breast: when is excision necessary? AJR Am J Roentgenol. 179(5):1179-84, 2002
                                              49. Alvarado-Cabrero I et al: Neoplastic and malignant lesions involving or arising in a radial scar: a clinicopathologic analysis of 17 cases. Breast J. 6(2):96-102, 2000
                                              50. Cohen MA et al: Role of sonography in evaluation of radial scars of the breast. AJR Am J Roentgenol. 174(4):1075-8, 2000
                                              51. Kirwan SE et al: Multiple 14G stereotactic core biopsies in the diagnosis of mammographically detected stellate lesions of the breast. Clin Radiol. 55(10):763-6, 2000
                                              52. Philpotts LE et al: Uncommon high-risk lesions of the breast diagnosed at stereotactic core-needle biopsy: clinical importance. Radiology; 216:831-7, 2000
                                              53. Reynolds HE: Core needle biopsy of challenging benign breast conditions: a comprehensive literature review. AJR Am J Roentgenol. 174(5):1245-50, 2000
                                              54. Hassell P et al: Radial sclerosing lesions of the breast: mammographic and pathologic correlation. Can Assoc Radiol J. 50(6):370-5, 1999
                                              55. Jackman RJ et al: Stereotactic, automated, large-core needle biopsy of nonpalpable breast lesions: false-negative and histologic underestimation rates after long-term follow-up. Radiology. 210(3):799-805, 1999
                                              56. Jacobs TW et al: Radial scars in benign breast-biopsy specimens and the risk of breast cancer. N Engl J Med. 340(6):430-6, 1999
                                              57. Frouge C et al: Mammographic lesions suggestive of radial scars: microscopic findings in 40 cases. Radiology. 195(3):623-5, 1995
                                              58. Sloane JP et al: Carcinoma and atypical hyperplasia in radial scars and complex sclerosing lesions: importance of lesion size and patient age. Histopathology. 23(3):225-31, 1993
                                              59. Orel SG et al: Radial scar with microcalcifications: radiologic-pathologic correlation. Radiology. 183(2):479-82, 1992
                                              60. Adler DD et al: Radial sclerosing lesion of the breast: mammographic features. Radiology. 176(3):737-40, 1990
                                              61. Nielsen M et al: An autopsy study of radial scar in the female breast. Histopathology. 9(3):287-95, 1985
                                              Related Anatomy
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                                              Related Differential Diagnoses
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                                              References
                                              Tables

                                              Tables

                                              KEY FACTS

                                              • Terminology

                                                • Imaging

                                                  • Top Differential Diagnoses

                                                    • Pathology

                                                      • Clinical Issues

                                                        TERMINOLOGY

                                                        • Synonyms

                                                          • Scleroelastotic lesion, sclerosing papillary lesion
                                                        • Definitions

                                                          • Radial scar (RS): Benign proliferative lesion with central fibroelastosis and spiculated appearance radiographically and histologically
                                                          • Complex sclerosing lesion (CSL): RS > 1 cm in size
                                                          • Radial sclerosing lesion (RSL): Refers to both RS & CSL
                                                          • Incidental radial scar: Microscopic, entirely contained within core biopsy specimen as part of biopsy targeted to finding other than distortion or spiculated mass, e.g., adjacent to targeted calcifications

                                                        IMAGING

                                                        • General Features

                                                          • Mammographic Findings

                                                            • Ultrasonographic Findings

                                                              • MR Findings

                                                                • Image-Guided Biopsy

                                                                  • Imaging Recommendations

                                                                    DIFFERENTIAL DIAGNOSIS

                                                                      PATHOLOGY

                                                                      • General Features

                                                                        • Gross Pathologic & Surgical Features

                                                                          • Microscopic Features

                                                                            CLINICAL ISSUES

                                                                            • Presentation

                                                                              • Demographics

                                                                                • Natural History & Prognosis

                                                                                  • Treatment

                                                                                    DIAGNOSTIC CHECKLIST

                                                                                    • Consider

                                                                                      • Image Interpretation Pearls

                                                                                        • Reporting Tips

                                                                                          Selected References

                                                                                          1. Alshafeiy TI et al: Outcome of architectural distortion detected only at breast tomosynthesis versus 2D mammography. Radiology. 288(1):38-46, 2018
                                                                                          2. Calhoun BC: Core Needle biopsy of the breast: an evaluation of contemporary data. Surg Pathol Clin. 11(1):1-16, 2018
                                                                                          3. Chou WYY et al: Radial scar on image-guided breast biopsy: is surgical excision necessary? Breast Cancer Res Treat. 170(2):313-20, 2018
                                                                                          4. Nakhlis F et al: Complex sclerosing lesions and radial sclerosing lesions on core needle biopsy: low risk of carcinoma on excision in cases with clinical and imaging concordance. Breast J. 24(2):133-8, 2018
                                                                                          5. Speer ME et al: High risk breast lesions identified on MRI-guided vacuum assisted needle biopsy: outcome of surgical excision and imaging follow-up. Br J Radiol. 20180300, 2018
                                                                                          6. Bahl M et al: Pathologic outcomes of architectural distortion on digital 2D versus tomosynthesis mammography. AJR Am J Roentgenol. 209(5):1162-7, 2017
                                                                                          7. Cohen MA and Newell MS: Radial scars of the breast encountered at core biopsy: review of histologic, imaging, and management considerations. AJR Am J Roentgenol. 209(5):1168-77, 2017
                                                                                          8. Ferreira AI et al: Radial scar of the breast: Is it possible to avoid surgery? Eur J Surg Oncol. 43(7):1265-72, 2017
                                                                                          9. Mesa-Quesada J et al: Radial scars without atypia in percutaneous biopsy specimens: can they obviate surgical biopsy? Radiologia. 59(6):523-30, 2017
                                                                                          10. Racz JM et al: Challenging atypical breast lesions including flat epithelial atypia, radial scar, and intraductal papilloma. Ann Surg Oncol. 24(10):2842-7, 2017
                                                                                          11. Donaldson AR et al: Radial scars diagnosed on breast core biopsy: frequency of atypia and carcinoma on excision and implications for management. Breast. 30:201-7, 2016
                                                                                          12. Hou Y et al: Surgical excision outcome after radial scar without atypical proliferative lesion on breast core needle biopsy: a single institutional analysis. Ann Diagn Pathol. 21:35-8, 2016
                                                                                          13. Kalife ET et al: Clinical and radiologic follow-up study for biopsy diagnosis of radial scar/radial sclerosing lesion without other atypia. Breast J. 22(6):637-44, 2016
                                                                                          14. Leong RY et al: Radial scar at percutaneous breast biopsy that does not require surgery. J Am Coll Surg. 223(5):712-6, 2016
                                                                                          15. Li Z et al: Pathologic findings of follow-up surgical excision for radial scar on breast core needle biopsy. Hum Pathol. 48:76-80, 2016
                                                                                          16. Park VY et al: Mammographically occult asymptomatic radial scars/complex sclerosing lesions at ultrasonography-guided core needle biopsy: follow-up can be recommended. Ultrasound Med Biol. 42(10):2367-71, 2016
                                                                                          17. Rageth CJ et al: First International Consensus Conference on lesions of uncertain malignant potential in the breast (B3 lesions). Breast Cancer Res Treat. 159(2):203-13, 2016
                                                                                          18. Matrai C et al: Advocating Nonsurgical management of patients with small, incidental radial scars at the time of needle core biopsy: a study of 77 cases. Arch Pathol Lab Med. 139(9):1137-42, 2015
                                                                                          19. Nassar A et al: Radial scar/complex sclerosing lesions: a clinicopathologic correlation study from a single institution. Ann Diagn Pathol. 19(1):24-8, 2015
                                                                                          20. Miller CL et al: Surgical excision of radial scars diagnosed by core biopsy may help predict future risk of breast cancer. Breast Cancer Res Treat. 145(2):331-8, 2014
                                                                                          21. Bianchi S et al: Radial scar without associated atypical epithelial proliferation on image-guided 14-gauge needle core biopsy: analysis of 49 cases from a single-centre and review of the literature. Breast. 21(2):159-64, 2012
                                                                                          22. Heller SL et al: Imaging features and management of high-risk lesions on contrast-enhanced dynamic breast MRI. AJR Am J Roentgenol. 198(2):249-55, 2012
                                                                                          23. Krishnamurthy S et al: Multidisciplinary considerations in the management of high-risk breast lesions. AJR Am J Roentgenol. 198(2):W132-40, 2012
                                                                                          24. Lee KA et al: Risk of malignancy when microscopic radial scars and microscopic papillomas are found at percutaneous biopsy. AJR Am J Roentgenol. 198(2):W141-5, 2012
                                                                                          25. Linda A et al: Magnetic resonance imaging of radial sclerosing lesions (radial scars) of the breast. Eur J Radiol. 81(11):3201-7, 2012
                                                                                          26. Linda A et al: Nonsurgical management of high-risk lesions diagnosed at core needle biopsy: can malignancy be ruled out safely with breast MRI? AJR Am J Roentgenol. 198(2):272-80, 2012
                                                                                          27. Londero V et al: High-risk breast lesions at imaging-guided needle biopsy: usefulness of MRI for treatment decision. AJR Am J Roentgenol. 199(2):W240-50, 2012
                                                                                          28. Morgan C et al: The radial scar of the breast diagnosed at core needle biopsy. Proc (Bayl Univ Med Cent). 25(1):3-5, 2012
                                                                                          29. Tabar L et al: Teaching Atlas of Mammography. 4th ed. Stuttgart, Germany: Thieme, 2012
                                                                                          30. Crystal P et al: High-risk lesions diagnosed at MRI-guided vacuum-assisted breast biopsy: can underestimation be predicted? Eur Radiol. 21(3):582-9, 2011
                                                                                          31. Osborn G et al: A review of needle core biopsy diagnosed radial scars in the Welsh Breast Screening Programme. Ann R Coll Surg Engl. 93(2):123-6, 2011
                                                                                          32. Rajan S et al: Conservative management of screen-detected radial scars: role of mammotome excision. J Clin Pathol. 64(1):65-8, 2011
                                                                                          33. Resetkova E et al: Management of radial sclerosing lesions of the breast diagnosed using percutaneous vacuum-assisted core needle biopsy: recommendations for excision based on seven years' of experience at a single institution. Breast Cancer Res Treat. 127(2):335-43, 2011
                                                                                          34. Linda A et al: Radial scars without atypia diagnosed at imaging-guided needle biopsy: how often is associated malignancy found at subsequent surgical excision, and do mammography and sonography predict which lesions are malignant? AJR Am J Roentgenol. 194(4):1146-51, 2010
                                                                                          35. Pediconi F et al: Role of breast MR imaging for predicting malignancy of histologically borderline lesions diagnosed at core needle biopsy: prospective evaluation. Radiology. 257(3):653-61, 2010
                                                                                          36. Sohn VY et al: The treatment of radial scars in the modern era--surgical excision is not required. Am Surg. 76(5):522-5, 2010
                                                                                          37. Perfetto F et al: Adjunctive diagnostic value of MRI in the breast radial scar. Radiol Med. 114(5):757-70, 2009
                                                                                          38. Berg JC et al: Breast cancer risk in women with radial scars in benign breast biopsies. Breast Cancer Res Treat. 108(2):167-74, 2008
                                                                                          39. Manfrin E et al: Risk of neoplastic transformation in asymptomatic radial scar. Analysis of 117 cases. Breast Cancer Res Treat. 107(3):371-7, 2008
                                                                                          40. Douglas-Jones AG et al: Radial scar lesions of the breast diagnosed by needle core biopsy: analysis of cases containing occult malignancy. J Clin Pathol. 60(3):295-8, 2007
                                                                                          41. Doyle EM et al: Radial scars/complex sclerosing lesions and malignancy in a screening programme: incidence and histological features revisited. Histopathology. 50(5):607-14, 2007
                                                                                          42. Becker L et al: Management of radial scars found at percutaneous breast biopsy. Can Assoc Radiol J. 57(2):72-8, 2006
                                                                                          43. López-Medina A et al: Radial scars diagnosed at stereotactic core-needle biopsy: surgical biopsy findings. Eur Radiol. 16(8):1803-10, 2006
                                                                                          44. Sanders ME et al: Interdependence of radial scar and proliferative disease with respect to invasive breast carcinoma risk in patients with benign breast biopsies. Cancer. 106(7):1453-61, 2006
                                                                                          45. Pediconi F et al: Radial scars of the breast: contrast-enhanced magnetic resonance mammography appearance. Breast J. 11(1):23-8, 2005
                                                                                          46. Brodie C et al: Fourteen-gauge needle core biopsy of mammographically evident radial scars: is excision necessary? Cancer. 100(3):652-3; author reply 653-4, 2004
                                                                                          47. Cawson JN et al: Fourteen-gauge needle core biopsy of mammographically evident radial scars: is excision necessary? Cancer. 97(2):345-51, 2003
                                                                                          48. Brenner RJ et al: Percutaneous core needle biopsy of radial scars of the breast: when is excision necessary? AJR Am J Roentgenol. 179(5):1179-84, 2002
                                                                                          49. Alvarado-Cabrero I et al: Neoplastic and malignant lesions involving or arising in a radial scar: a clinicopathologic analysis of 17 cases. Breast J. 6(2):96-102, 2000
                                                                                          50. Cohen MA et al: Role of sonography in evaluation of radial scars of the breast. AJR Am J Roentgenol. 174(4):1075-8, 2000
                                                                                          51. Kirwan SE et al: Multiple 14G stereotactic core biopsies in the diagnosis of mammographically detected stellate lesions of the breast. Clin Radiol. 55(10):763-6, 2000
                                                                                          52. Philpotts LE et al: Uncommon high-risk lesions of the breast diagnosed at stereotactic core-needle biopsy: clinical importance. Radiology; 216:831-7, 2000
                                                                                          53. Reynolds HE: Core needle biopsy of challenging benign breast conditions: a comprehensive literature review. AJR Am J Roentgenol. 174(5):1245-50, 2000
                                                                                          54. Hassell P et al: Radial sclerosing lesions of the breast: mammographic and pathologic correlation. Can Assoc Radiol J. 50(6):370-5, 1999
                                                                                          55. Jackman RJ et al: Stereotactic, automated, large-core needle biopsy of nonpalpable breast lesions: false-negative and histologic underestimation rates after long-term follow-up. Radiology. 210(3):799-805, 1999
                                                                                          56. Jacobs TW et al: Radial scars in benign breast-biopsy specimens and the risk of breast cancer. N Engl J Med. 340(6):430-6, 1999
                                                                                          57. Frouge C et al: Mammographic lesions suggestive of radial scars: microscopic findings in 40 cases. Radiology. 195(3):623-5, 1995
                                                                                          58. Sloane JP et al: Carcinoma and atypical hyperplasia in radial scars and complex sclerosing lesions: importance of lesion size and patient age. Histopathology. 23(3):225-31, 1993
                                                                                          59. Orel SG et al: Radial scar with microcalcifications: radiologic-pathologic correlation. Radiology. 183(2):479-82, 1992
                                                                                          60. Adler DD et al: Radial sclerosing lesion of the breast: mammographic features. Radiology. 176(3):737-40, 1990
                                                                                          61. Nielsen M et al: An autopsy study of radial scar in the female breast. Histopathology. 9(3):287-95, 1985