{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T07:07:28Z","timestamp":1793862448668,"version":"4.6.1"},"reference-count":62,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2019,10,18]],"date-time":"2019-10-18T00:00:00Z","timestamp":1571356800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Histopathology"],"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:sec><jats:title>Aims<\/jats:title><jats:p>The diagnosis of radial scars\/complex sclerosing lesions (RSs\/CSLs) onpercutaneous biopsy carries a risk of histological underestimation. Consequently, surgical excision is often performed in order to exclude a possible associated malignancy. The aim of this study was to assess the rate of \u2018upgrade to carcinoma\u2019 upon subsequent surgical excision of RS\/CSL cases diagnosed on vacuum\u2010assisted large\u2010core biopsy (VALCB). We also analysed the risk factors for upgrade in order to determine a subset of patients who could avoid surgery and benefit from conservative management with clinical and imaging follow\u2010up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and results<\/jats:title><jats:p>This was a retrospective observational single\u2010centre study on 174 consecutive RS\/CSL cases diagnosed on VALCB from May 2008 to October 2015. Univariate analysis was performed to identify clinical, radiological and histological risk factors for upgrade. Surgical excision was performed following VALCB diagnosis of 88 RS\/CSL cases with or without associated atypia. The overall rate of surgical upgrade to carcinoma was 9.1% (8\/88). None of the benign biopsies without atypia was surgically upgraded. Additional to atypia, risk factors for upgrade were non\u2010incidental finding of the RS\/CSL, the mammographic appearance, and the number of fragments obtained during the biopsy procedure (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>We demonstrate that VALCB revealing an RS\/CSL is reliable for excluding malignancy when there is no associated atypia and when radiological and histological findings are concordant. In such cases, surgery can be avoided in favour of clinical and imaging follow\u2010up. When an RS\/CSL is associated with atypia, the decision to perform surgical excision depends on other associated risk factors.<\/jats:p><\/jats:sec>","DOI":"10.1111\/his.13950","type":"journal-article","created":{"date-parts":[[2019,7,9]],"date-time":"2019-07-09T06:58:40Z","timestamp":1562655520000},"page":"900-915","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Management of radial scars\/complex sclerosing lesions of the breast diagnosed on vacuum\u2010assisted large\u2010core biopsy: is surgery always necessary?"],"prefix":"10.1111","volume":"75","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0846-5155","authenticated-orcid":false,"given":"Julia","family":"Bacci","sequence":"first","affiliation":[{"name":"Medical Imaging Department Institut Bergoni\u00e9 Bordeaux, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ga\u00ebtan","family":"MacGrogan","sequence":"additional","affiliation":[{"name":"Department of Biopathology Institut Bergoni\u00e9 Bordeaux France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L\u00e9onie","family":"Alran","sequence":"additional","affiliation":[{"name":"Department of Biopathology Institut Bergoni\u00e9 Bordeaux France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabrielle","family":"Labrot\u2010Hurtevent","sequence":"additional","affiliation":[{"name":"Medical Imaging Department Institut Bergoni\u00e9 Bordeaux, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,10,18]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198501173120303"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2006.09.0217"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1080\/08998280.2012.11928768"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.11.7799"},{"key":"e_1_2_7_6_1","first-page":"120","volume-title":"Diagnostic histopathology of the breast","author":"Page D","year":"1987"},{"key":"e_1_2_7_7_1","first-page":"34","volume-title":"Pathology of benign breast disorders","author":"Schnitt SJ","year":"1996"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.21730"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.11070"},{"key":"e_1_2_7_10_1","first-page":"1","article-title":"Breast carcinoma. 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