RSNA 2010 

Abstract Archives of the RSNA, 2010


LL-BRS-TU4A

Flat Epithelial Atypia Diagnosed on Core Needle Biopsy: Potential Implications for Management

Scientific Informal (Poster) Presentations

Presented on November 30, 2010
Presented as part of LL-BRS-TU: Breast Imaging

Participants

Benjamin Kianmahd BS, Presenter: Nothing to Disclose
Jilbert Eradat MD, Abstract Co-Author: Nothing to Disclose
Sophia K. Apple MD, Abstract Co-Author: Nothing to Disclose
Lawrence W. Bassett MD, Abstract Co-Author: Scientific Advisory Committee, Hologic, Inc

PURPOSE

Columnar cell lesions (CCL) encompass a spectrum including columnar cell change (CCC), columnar cell hyperplasia (CCH) and flat epithelial atypia (FEA). Currently there is no standard of practice as to how to manage these lesions. The purpose of the study is to evaluate the prevalence of occult breast carcinoma in surgical biopsies performed on lesions diagnosed by core needle biopsy (CNB) as FEA.

METHOD AND MATERIALS

Pathology and imaging data were reviewed for all cases of CNB detected FEA between April 2003 and December 2009. FEA on CNB was routinely recommended at our institution.

RESULTS

We identified 39 cases of FEA diagnosed on CNB and 31 patients underwent excision. BIRADS for the 31 cases are as follows: 2 cases (6%) of BIRADS 3, 9 cases (29%) 4a, and 20 cases (65 %) 4b. Overall, 5 occult DCIS (16%) and 12 occult ADH (39%) was found out of 31 excision. With BI-RADS 3, none were upgraded to DCIS and 1 (50%) case was upgraded to ADH. With BI-RADS 4a, none were upgraded to DCIS and 4 (44 %) cases were upgraded to ADH. With BI-RADS 4b, 5 (25%) were upgraded to DCIS and 7 (35%) cases were upgraded to ADH.

CONCLUSION

Despite no malignancy, FEA diagnosed on CNB frequently revealed lesions at moderate-to high risk of breast cancer. We found that 16% and 39% of patients with FEA on CNB have occult carcinoma and ADH, respectively.

CLINICAL RELEVANCE/APPLICATION

Routine excision of CNB diagnosed FEA revealed DCIS/ADH in 54% There is a high association of breast cancer risk with the finding of FEA at CNB, therefore excisional biopsy may be warranted.

Cite This Abstract

Kianmahd, B, Eradat, J, Apple, S, Bassett, L, Flat Epithelial Atypia Diagnosed on Core Needle Biopsy: Potential Implications for Management.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9013872.html