Morphological parameters of flat epithelial atypia (FEA) in stereotactic vacuum-assisted needle core biopsies do not predict the presence of malignancy on subsequent surgical excision

Simonetta Bianchi, Benedetta Bendinelli, Isabella Castellano, Quirino Piubello, Giuseppe Renne, Maria Grazia Cattani, Domenica Di Stefano, Giovanna Carrillo, Licia Laurino, Alessandra Bersiga, Carmela Giardina, Stefania Dante, Carla Di Loreto, Carmela Quero, Concetta Maria Antonacci, Domenico Palli

Research output: Contribution to journalArticlepeer-review

Abstract

Flat epithelial atypia (FEA) may represent the earliest precursor of low-grade breast cancer and often coexists with more advanced atypical proliferative breast lesions such as atypical ductal hyperplasia (ADH) and lobular intraepithelial neoplasia (LIN). The present study aims to investigate the association between morphological parameters of FEA and presence of malignancy at surgical excision (SE) and the clinical significance of the association of FEA with ADH and/or LIN. This study included 589 cases of stereotactic 11-gauge vacuum-assisted needle core biopsy (VANCB), reporting a diagnosis of FEA, ADH or LIN with subsequent SE from 14 pathology departments in Italy. Available slides were reviewed, with 114 (19.4 %) showing a malignant outcome at SE. Among the 190 cases of pure FEA, no statistically significant association emerged between clinical-pathological parameters of FEA and risk of malignancy. Logistic regression analyses showed an increased risk of malignancy according to the extension of ADH among the 275 cases of FEA associated with ADH (p=0.004) and among the 34 cases of FEA associated with ADH and LIN (p=0.02). In the whole series, a statistically significant increased malignancy risk emerged according to mammographic R1-R3/R4-R5 categories (OR=1.56; p= 0.04), extension (OR=1.24; p=0.04) and grade (OR=1.94; p=0.004) of cytological atypia of FEA. The presence of ADH was associated with an increased malignancy risk (OR=2.85; p

Original languageEnglish
Pages (from-to)405-417
Number of pages13
JournalVirchows Archiv
Volume461
Issue number4
DOIs
Publication statusPublished - Oct 2012

Keywords

  • Breast
  • Flat epithelial atypia
  • Malignancy
  • Stereotactic vacuum-assisted needle core biopsy
  • Surgical excision

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Cell Biology
  • Molecular Biology

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