Complex sclerosing lesion (CSL)/radial scar and carcinoma of breast can both present mammographically as stellate lesions. The mammographic features used to distinguish these two entities are reported as being unreliable. All reports to date indicate that CSLs are not palpable. Of the 54,407 women screened in the first 2 1/2 years of the Warwickshire, Solihull and Coventry Breast Screening Service, 24 histologically-proven CSLs were identified. This represents an incidence of 0.04%. In six (25%) of these patients a corresponding clinically-palpable abnormality was identified. We found no imaging or histological features that differentiated the palpable lesions from the impalpable lesions. It is important not to assume that a palpable stellate lesion is a carcinoma.