Benign radial scars, lesions characterised histologically by a fibroelastic core surrounded by stellate duct proliferation, cannot be differentiated from lesions with associated invasive or non-invasive carcinoma on imaging, and histological sampling is therefore mandatory. There is also extensive evidence of the frequency with which radial scars are associated with malignancy and with other lesions that have an associated risk of malignancy. The traditionally accepted management has been the surgical excision of all suspected radial scars because insufficient tissue was removed by standard biopsy techniques to exclude associated lesions. In more recent series, it has been shown that with extensive tissue sampling of such lesions with core biopsy and modern vacuum-assisted sampling devices, the presence of associated malignancy can be excluded, thus negating the need for surgical excision.