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

Purpose: To describe the magnetic resonance characteristics of radial scars/complex sclerosing lesions (RS/CSL) of the breast using the current BI-BADS 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) m/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.

Automated summary

The study aimed to describe the magnetic resonance characteristics of radial scars/complex sclerosing lesions (RS/CSL) of the breast using the current BI-BADS lexicon, and investigate the value of diffusion weighted imaging for predicting malignancy. The majority of RS/CSL showed enhancement at MR, predominantly presenting as non-mass, focal, heterogeneous internal enhancement. All cases associated with cancer showed non-mass enhancement.