Case 30 Answer
Radial Scar. This finding is focal architectural distortion without a central density or mass. One could argue that there may be a tiny 2mm spiculated mass on the CC spot mag, but this could not be shown on MLO or Lat views (take another look at the MLO view).
Though this area could represent fibrosis, this would be unlikely since fibrosis rarely causes spiculations seen in this case. This would be an extremely unusual presentation for DCIS, which rarely causes architectural distortion, especially in such a focal manner. Mucinous carcinomas generally present as a mass.
Now if tubular carcinoma had been an option, that would also be possible. Tubular carcinomas are low-grade and tend to present as small spiculated masses.
What is your assessment?
- BI-RADS 2 - Benign - Recommend 12 month follow-up
- BI-RADS 3 - Probably Benign - Recommend 6 month follow-up
- BI-RADS 4 - Suspicious - Recommend core needle biopsy
- BI-RADS 4 - Suspicious - Recommend wire localization and surgical excision
- BI-RADS 5 - Highly Suggestive of Malignancy - Recommend wire localization and surgical excision