(redirected from Flat Epithelial Atypia)
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References in periodicals archive ?
Abbreviations: ADH, atypical ductal hyperplasia; ALH, atypical lobular hyperplasia; DCIS, ductal carcinoma in situ; FEA, flat epithelial atypia; IC, invasive carcinoma; LCIS, lobular carcinoma in situ.
(%) Abbreviations: ADH, atypical ductal hyperplasia; ALH, atypical lobular hyperplasia; CCC, columnar cell change; DCIS, ductal carcinoma in situ; FCC, fibrocystic change; FEA, flat epithelial atypia; H/o, history of; LCIS, lobular carcinoma in situ.
Fourteen (19%) of the 55 benign lesions were high risk (5 atypical ductal hyperplasia [ADH], 6 papillary lesions, 2 lobular neoplasia, and 1 flat epithelial atypia).
The final diagnosis did not change in one case of flat epithelial atypia, in 2 cases of NME LCIS, 2 cases of masses and 3 NME lesions diagnosed as papillary lesion and 3 cases of NME lesions diagnosed as ADH after surgical excision.
Surgical excision results of high-risk lesions Surgical excision MRI-guided Upgrade to VABB (n=14) No upgrade Upgrade to DCIS invasive cancer ADH (n=5) 3 2 0 Papillary lesion (n=6) 5 1 0 LCIS (n=2) 2 0 0 Flat epithelial atypia (n=1) 1 0 0 Total 11 3 0 VABB, vacuum-assisted breast biopsy; DCIS, ductal carcinoma in situ; ADH, atypical ductal ectasia; LCIS, lobular carcinoma in situ.
Invasive tubular carcinoma of the breast frequently is clonally related to flat epithelial atypia and low-grade ductal carcinoma in situ.
Some studies report a similar frequency for the diagnosis of flat epithelial atypia (FEA) alone on core biopsy, (27) suggesting that there could be 100 000 core biopsy diagnoses of "atypia" in 2013.
Dr Farid Moinfar provides a detailed review of the flat ductal intraepithelial neoplasia 1 (flat epithelial atypia), a lesion beautifully described by Azzopardi5 in 1979.
Meanwhile, several investigators have found association of tubular carcinoma, as well as lobular intraepithelial neoplasia (LIN), with clinging pattern in breast biopsies (7-10) and have published this distinct morphologic change under a variety of terms such as atypical cystic lobules, (11,12) atypical lobules type A, (13) atypical cystic duct, (14,15) columnar cell change with atypia, (16-18) columnar alteration with prominent apical snouts and secretion, (19-21) columnar cell hyperplasia (with or without atypia), (22-25) small ectatic ducts lined by atypical cells with apocrine snouts, (26) ductal intraepithelial neoplasia (DIN), flat type, (2,6,27) flat epithelial atypia, (16,28-30) and enlarged lobular units with columnar alteration.
In the following discussion, flat epithelial atypia or DIN1a is designated low-grade flat DIN (see rational for adopting DIN terminology).
Although several cases included intraductal proliferative areas of usual ductal hyperplasia, ADH, and low-grade DCIS, flat epithelial atypia (columnar cell change with cytologic atypia and columnar cell hyperplasia with cytologic atypia) were found in 10 cases.