Radial sclerosing lesion (RSL) with low grade DCIS

Case contributed by Dr Amro Omar


Screening mammography

Patient Data

Age: 58

Left breast shows ill defined speculated lesion with architectural distortion and central lucency in the 11 o'clock position, zone C. 

US shows an irregular, hypoechoic mass with posterior shadowing. Radial sclerosing lesion (RSL) was suspected, though cancer can have the same appearance.

Case Discussion

US-guided core biopsy was performed and resulted in RSL without atypia. Because of the risk of associated malignancy, excision was recommended.

The spiculated mass was excised and the diagnosis of RSL is confirmed, together with a tiny focus of low grade DCIS.

Top differential diagnoses of RSL:

  • tubular carcinoma
  • invasive ductal carcinoma (IDC) NOS
  • invasive lobular carcinoma (ILC)
  • postsurgical scar

RSL shows 1.8 x relative risk of developing invasive breast carcinoma , 2.8 x relative risk if associated with atypia. 

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Case information

rID: 33898
Published: 28th Jan 2015
Last edited: 14th Aug 2019
System: Breast
Inclusion in quiz mode: Included

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