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