Clinical Relevance of Radial Scars: A Review of the Current Literature

The objective of this review was to examine the current literature and clinical relevance of radial scars. We discuss the diagnostic workup of radial scars, factors impacting upgrade rates to malignancy, and current issues in management.

Several guidelines exist with varying recommendations on the management of radial scars. Early studies advocated for the excision of all radial scars to definitively exclude cancer. However, there is growing evidence that some lesions may be observed with serial imaging.

Numerous factors contribute to the risk of upgrading radial scars to malignancy. The presence of atypia, level of enhancement on magnetic resonance imaging, and the method of tissue biopsy can impact the risk of upgrade. Radial scars without atypia and non-enhancement on MRI that are sampled with a vacuum-assisted device have low risks of upgrade and may be candidates for non-operative management with close surveillance.