1. What is a sclerosing lesion of the breast?
2. What is sclerosing adenosis?
3. What are the symptoms of sclerosis adenosis?
4. How is sclerosing adenosis diagnosed?
5. How is sclerosing adenosis treated?
6. Can sclerosis adenosis increase your risk of breast cancer?
7. What are radial scars and complex sclerosing lesions?
8. What are the symptoms of radial scars and complex sclerosing lesions?
9. How are radial scars and complex sclerosing lesions diagnosed?
10. How are radial scars and complex sclerosing lesions treated?
11. Can radial scars and complex sclerosing lesions increase your risk of breast cancer?
12. Being breast aware
A sclerosing lesion of the breast is a benign (not cancer) area of hardened breast tissue. You may also hear it called ‘sclerosis of the breast’.
The most common types of sclerosing lesion of the breast are:
• sclerosing adenosis
• radial scar/complex sclerosing lesion
They are more common in women in their 30s or 40s, but can occur at any age.
Men can also get sclerosing lesions of the breast but this is very rare.
Sclerosing adenosis is a benign breast condition that may occur as the result of the normal ageing process. 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 extra growth of tissue within the breast lobules.
Most women will not notice any symptoms and it is often only diagnosed during a routine mammogram (breast x-ray) or following tests for a different breast problem.
Occasionally some people may notice a small lump. Others may have pain in their breast, but this is very rare. If there is pain it usually doesn’t go away and is in one specific area. Some women find that the pain gets worse just before a period.
Sclerosing adenosis can be difficult to diagnose, as it can occasionally look like a breast cancer on a mammogram. Because of this, a biopsy may be needed to make a definite diagnosis. You may have one of the following types of biopsy:
• core biopsy
• stereotactic core biopsy
• vacuum assisted biopsy
A core biopsy uses a hollow needle to take a sample of breast tissue. The sample will be sent to a laboratory to be looked at under a microscope. Several tissue samples may be taken at the same time.
Stereotactic core biopsy
If the area of concern can only be seen on a mammogram, you may have a stereotactic core biopsy. This is where a sample of tissue is taken using a needle biopsy device connected to a mammogram machine and linked to a computer. This helps locate the exact position of the area to be biopsied. Images of the breast are taken from two different angles to help guide the needle to the precise location. You will be given a local anaesthetic and will be in a sitting position or lying down on a specially designed examination couch.
Vacuum assisted biopsy
If a previous biopsy has not given a definite result and more breast tissue is needed to make a diagnosis, or the area of concern is difficult to target, you may be offered a vacuum assisted biopsy. This procedure takes a little longer than a core biopsy and is done using a mammogram or ultrasound for guidance.
Occasionally a small operation (excision biopsy) is needed to remove the affected area and confirm that it is not breast cancer. Once the affected area is removed, the tissue is sent to a laboratory where it is looked at under a microscope to confirm the diagnosis.
Once the diagnosis has been confirmed as sclerosing adenosis, no further treatment is needed, even if the area of concern has not been removed.
Sclerosing adenosis does not increase your risk of developing breast cancer. Even though it doesn’t increase your risk, you may still worry about breast cancer. Breast cancer is common so it’s important to be breast aware. Knowing the signs and symptoms to be aware of can help you feel less anxious.
Radial scars and complex sclerosing lesions are also benign areas of hardened breast tissue. They are similar to sclerosing adenosis, but they are usually larger and have features similar to a breast cancer when seen on a mammogram.
They are generally identified by size, with radial scars usually being smaller than 1cm and complex sclerosing lesions being more than 1cm.
A radial scar or complex sclerosing lesion is not actually a scar. The name describes how it looks on a mammogram.
Most people will not notice any symptoms and these are often only found on a routine mammogram or following tests for another breast problem.
It may not be possible to clearly identify radial scars and complex sclerosing lesions from breast cancer on a mammogram. Therefore, your doctor may suggest you have a core biopsy to confirm the diagnosis.
Even though the diagnosis can usually be made on a core biopsy, your doctor may suggest a small operation (excision biopsy) to completely remove the radial scar or complex sclerosing lesion.
Sometimes your doctor may suggest doing a vacuum-assisted biopsy to remove it instead of an excision biopsy. The biopsy device is used until the area being investigated has been removed. This may mean that an operation under a general anaesthetic can be avoided.
The removed breast tissue will be sent to a laboratory to confirm that it’s not cancer.
Once the area has been completely removed and confirmed as a radial scar or complex sclerosing lesion, follow-up mammograms may be necessary. Your specialist team will discuss this with you.
Experts disagree as to whether having a radial scar or complex sclerosing lesion might mean a slightly increased risk of developing breast cancer in the future. Some doctors believe that any increase in your risk is determined by what else (if anything) is found in the tissue removed, for example an area of atypical hyperplasia, but more research is needed.
It’s important to continue to be breast aware and go back to your GP if you notice any other changes in your breasts, regardless of how soon these occur after your diagnosis of a sclerosing lesion.