Evidence map›Paper›PMID 42148712›Full record

ArticleWorld journal of surgery2026

Management of Radial Scars and Complex Sclerosing Lesions of the Breast: To Excise or Not to Excise?

Nicholas Zakem, Miranda Addie, Vanessa Josey, Anca Florea, Ipshita Prakash, Stephanie M Wong, Sarkis Meterissian

Abstract read
In one paragraph

Article in World journal of surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Nicholas ZakemFaculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada.
Miranda AddieFaculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada.
Vanessa JoseyBreast Center, McGill University Health Centre, Montreal, Quebec, Canada.
Anca FloreaDepartment of Pathology, Jewish General Hospital, Montreal, Quebec, Canada.
Ipshita PrakashDivision of General Surgery, McGill University Health Centre, Montreal, Quebec, Canada.
Stephanie M WongDivision of General Surgery, McGill University Health Centre, Montreal, Quebec, Canada.
Sarkis MeterissianBreast Center, McGill University Health Centre, Montreal, Quebec, Canada.ORCID https://orcid.org/0009-0000-3453-6960

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundRadial scars (RS) and complex sclerosing lesions (CSL) are benign breast lesions often detected incidentally on imaging. Although historically managed with surgical excision, emerging evidence suggests that conservative management may be appropriate in selected patients. This study evaluated rates of upgrade and progression of RS and CSL and examined factors associated with surgical management and these outcomes.

methodsA retrospective cohort study was conducted at two academic centers affiliated with McGill University. Adult patients diagnosed with RS or CSL on image-guided core needle biopsy between 2010 and 2024 were included. Upgrade or progression was defined as a subsequent diagnosis of invasive carcinoma, carcinoma in situ (including ductal carcinoma in situ [DCIS] or pleomorphic lobular carcinoma in situ), or high-risk lesion (HRL), including atypical ductal hyperplasia (ADH). Descriptive statistics and univariate analysis were used to evaluate associations between clinicopathologic factors and outcomes.

resultsAmong 185 patients, 49 (26.5%) underwent surgical excision and 136 (73.5%) were managed non-operatively. Surgical pathology revealed 1 invasive carcinoma (2.0%), 5 DCIS (10.2%), and 4 HRL (8.2%). In the non-surgical group, 3 patients (2.2%) subsequently developed invasive carcinoma; no DCIS or HRL developed over a median follow-up of 37 months. Presence of a palpable mass was the only factor that predicted surgical management (OR 2.65, 95% CI 1.06-6.60, p = 0.036); no other clinicopathologic or imaging features were associated with upgrade or progression.

conclusionsAlthough the surgical cohort demonstrated a higher-than-expected upgrade rate, most upgrades consisted of DCIS or HRL, and progression among non-surgically managed patients was rare after more than 3 years of follow-up. These findings suggest that RS and CSL are rarely associated with clinically significant disease, supporting surveillance as an appropriate management strategy in contemporary practice.

Indexed as

Breast DiseasesBreast NeoplasmsCicatrixConservative TreatmentAdultAgedBiopsy, Large-Core NeedleBreastCarcinoma, Intraductal, NoninfiltratingDisease ProgressionFemaleHumansMiddle AgedRetrospective StudiesSclerosisbreast biopsycomplex sclerosing lesionexcisionradial scarsurveillanceupgrade rate

Identifiers

PMID42148712
PMCPMC13356566

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.