Flat Epithelial Atypia: Upgrade Rates and Risk-Stratification Approach to Support Informed Decision Making

Journal of the American College of Surgeons
Leslie R LambConstance D Lehman

Abstract

Our aim was to determine upgrade rates of pure flat epithelial atypia (FEA) to malignancy and higher-risk lesions and to identify patients with FEA at low risk for upgrade. Medical chart review from 2007 to 2016 identified 208 consecutive patients with pure FEA diagnosed by image-guided core needle biopsy who underwent surgical excision (96.2% [200 of 208]) or had at least 2 years of imaging follow-up (3.8% [8 of 208]). Medical records were reviewed for risk factors and surgical outcomes. Overall upgrade rate of FEA to malignancy was 2.4% (5 of 208). All 5 upgraded cases were ductal carcinoma in situ at operation. The upgrade rate to atypical ductal hyperplasia, lobular carcinoma in situ, or atypical lobular hyperplasia was 29.8% (62 of 208). The FEA lesions in patients with a genetic mutation were more likely to upgrade to malignancy than FEA lesions in patients without a genetic mutation (33.3% [1 of 3] vs 2.0% [4 of 205]; p < 0.01). The FEA lesions in patients with a personal history of breast cancer were more likely to upgrade to higher-risk lesions than those without a personal history (47.8% [11 of 23] vs 27.6% [51 of 185]; p = 0.046) but were not more likely to be upgraded to malignancy (0% [0 of 23] vs 2.7% [5 of 185]; ...Continue Reading

Citations

Apr 19, 2018·Radiology·Daniel B Kopans
Oct 1, 2019·Climacteric : the Journal of the International Menopause Society·M U UgurluB M Gulluoglu
Oct 15, 2019·The American Journal of Surgical Pathology·Anne GrabenstetterEdi Brogi
Sep 29, 2019·The Breast Journal·Marissa K SrourFarin Amersi
Dec 7, 2018·Breast Cancer Research and Treatment·Christoph J RagethZsuzsanna Varga
Dec 16, 2019·Breast Cancer : the Journal of the Japanese Breast Cancer Society·Satoko OkamotoDebra M Ikeda
Sep 25, 2020·ANZ Journal of Surgery·Yang Y HuangAnanda K Ponniah
Jan 14, 2021·AJR. American Journal of Roentgenology·Aya Y MichaelsGenevieve N Abbey
Nov 24, 2020·Radiologic Clinics of North America·Manisha Bahl

❮ Previous
Next ❯

Related Concepts

Related Feeds

Carcinoma, Ductal

Ductal carcinoma is a malignant neoplasm involving the ductal systems of any of a number of organs, such as the mammary glands, pancreas, prostate or lacrimal gland. Discover the latest research on ductal carcinoma here.

Carcinoma, Lobular

Lobular carcinoma is an invasive type of breast cancer in which lobules, areas of the breast that produce milk, undergo malignant transformation. Here is the latest research.