Sclerosis of the breast

Sclerosis of the breast is hardening of the breast tissue that can occur as the breast ages. Sclerosis is seen in three benign (not cancer) breast conditions:

• sclerosing adenosis
• radial scar
• complex sclerosing lesions.

What is sclerosing adenosis?

Breasts are made up of lobules (milk-producing glands) and ducts (tubes that carry milk to the nipple), which are surrounded by glandular, fibrous and fatty tissue. Sclerosing adenosis is a benign condition in which extra tissue grows within the breast lobules. It can cause recurring pain or result in a small, firm lump in the breast.

It is commonly seen as the breast ages, especially in women in their 30s and 40s, but can occur at any age. Most women will not notice any symptoms and it is often only diagnosed during a routine mammogram (breast x-ray) or following investigation of an unrelated breast condition.

Diagnosis

Your GP will refer you to a specialist at a breast clinic, where you may have a mammogram. On a mammogram, sclerosing adenosis can look like breast cancer. Because of this, a biopsy is generally needed to make a firm diagnosis. You are most likely to have:

• a core biopsy, which uses a larger needle to extract samples of breast tissue
• a stereotactic biopsy, which uses a mammogram machine linked to computer to pinpoint the area and guide the biopsy needle with greater accuracy
• a vacuum assisted biopsy, which takes a little longer than a core biopsy. A small cut is made in the skin, through which a hollow probe connected to a vacuum device is passed. Using a mammogram or ultrasound for guidance, breast tissue is sucked through the probe by the vacuum into a collecting chamber.

 

Although sclerosing adenosis can often be diagnosed with a core biopsy, a small operation might be needed to remove the affected area and confirm that it is not breast cancer.

Follow up

Following a clear diagnosis, no further treatment is required, although you may choose to take pain relief if needed.

What are radial scars and complex sclerosing lesions?

Radial scars and complex sclerosing lesions are benign conditions (not cancer). Radial scars are usually smaller than 1cm and complex sclerosing lesions cover larger areas. They are most common in women aged between 35 and 65.

A radial scar or complex sclerosing lesion is not actually a scar, despite the name.  They are areas of hardened breast tissue. Most women will not notice any symptoms and these conditions are often only found on a routine mammogram or during investigation of an unrelated breast condition.

It is not possible clearly to distinguish radial scars and complex sclerosing lesions from breast cancer on a mammogram. So your doctor may suggest you have a core biopsy, which removes small samples of breast tissue, to confirm the diagnosis. Sometimes they may suggest a vacuum assisted biopsy be done instead. See ‘Diagnosis’ (above) for more information about both these procedures.

Follow up

Your doctor will usually suggest a small operation (excision biopsy) to remove the radial scar or complex sclerosing lesion completely. Once this has been done  and confirmed as a radial scar, or a complex sclerosing lesion, no further tests or treatments will be needed.

There are differing opinions as to whether having a radial scar or complex sclerosing lesion may be associated with a slightly increased risk of developing breast cancer in the future. Some doctors believe that any increase in risk is determined by what else is found in the excised tissue, for example, an area of atypical hyperplasia.

 

Content last reviewed March 2012; next planned review 2013