Flat epithelial atypia and risk of breast cancer: A Mayo cohort study

Based on its cytologic features, and its co‐occurrence with atypical hyperplasia and breast cancer, flat epithelial atypia (FEA) has been proposed as a precursor lesion on the pathway to the development of breast cancer. It is often referred to as an “atypical” or high‐risk lesion. However, to the authors' knowledge, the long‐term risk of breast cancer in women with FEA is undefined.

[1]  H. Moshonov,et al.  Incidence of Breast Cancer in Patients with Pure Flat Epithelial Atypia Diagnosed at Core-Needle Biopsy of the Breast , 2012, Annals of Surgical Oncology.

[2]  L. Middleton.  Histologic Associations and Long-term Cancer Risk in Columnar Cell Lesions of the Breast: A Retrospective Cohort and a Nested Case-Control Study , 2009 .

[3]  Peter Devilee,et al.  Pathology and Genetics of Tumours of the Breast and Female Genital Organs , 2003 .

[4]  V. Bécette,et al.  Rates of upgrade to malignancy for 271 cases of flat epithelial atypia (FEA) diagnosed by breast core biopsy , 2012, Breast Cancer Research and Treatment.

[5]  B. O'Malley,et al.  Cancerization of small ectatic ducts of the breast by ductal carcinoma in situ cells with apocrine snouts: a lesion associated with tubular carcinoma. , 1997, American journal of clinical pathology.

[6]  I. Ellis,et al.  Morphologic and Molecular Evolutionary Pathways of Low Nuclear Grade Invasive Breast Cancers and Their Putative Precursor Lesions: Further Evidence to Support the Concept of Low Nuclear Grade Breast Neoplasia Family , 2008, The American journal of surgical pathology.

[7]  Lisa M Erzetich,et al.  Columnar Cell Change With Atypia (Flat Epithelial Atypia) on Breast Core Biopsy—Outcomes Following Open Excision , 2012, The breast journal.

[8]  Derek C. Radisky,et al.  Understanding the Premalignant Potential of Atypical Hyperplasia through Its Natural History: A Longitudinal Cohort Study , 2014, Cancer Prevention Research.

[9]  D. Sgroi,et al.  The molecular pathology of breast cancer progression , 2011, The Journal of pathology.

[10]  P. Schirmacher,et al.  Invasive Tubular Carcinoma of the Breast Frequently is Clonally Related to Flat Epithelial Atypia and Low-grade Ductal Carcinoma In Situ , 2009, The American journal of surgical pathology.

[11]  A. Vincent-Salomon,et al.  Columnar Cell Lesions of the Breast , 2003, Advances in Anatomic Pathology.

[12]  I. Ellis,et al.  High Frequency of Coexistence of Columnar Cell Lesions, Lobular Neoplasia, and Low Grade Ductal Carcinoma In Situ With Invasive Tubular Carcinoma and Invasive Lobular Carcinoma , 2007, The American journal of surgical pathology.

[13]  D. Visscher,et al.  Diagnosis and management of benign, atypical, and indeterminate breast lesions detected on core needle biopsy. , 2014, Mayo Clinic proceedings.

[14]  W D Dupont,et al.  Risk factors for breast cancer in women with proliferative breast disease. , 1985, The New England journal of medicine.

[15]  Sunil R Lakhani,et al.  The molecular genetics of breast cancer: the contribution of comparative genomic hybridization. , 2005, Pathology, research and practice.

[16]  R. Millis,et al.  Problems in Breast Pathology , 2006, Virchows Archiv.

[17]  Y. Robin,et al.  Pure flat epithelial atypia: is there a place for routine surgery? , 2013, Diagnostic and interventional imaging.

[18]  P. Tan,et al.  Intraductal Proliferative Lesions , 2017 .

[19]  T. Nakajima,et al.  Atypical cystic lobule of the breast: An early stage of low-grade ductal carcinomain-situ , 2000, Breast cancer.

[20]  V Shane Pankratz,et al.  Benign breast disease and the risk of breast cancer. , 2005, The New England journal of medicine.

[21]  L Duchateau,et al.  Risk factors for recurrence and metastasis after breast-conserving therapy for ductal carcinoma-in-situ: analysis of European Organization for Research and Treatment of Cancer Trial 10853. , 2001, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[22]  G. Colditz,et al.  Columnar cell lesions and subsequent breast cancer risk: a nested case-control study , 2010, Breast Cancer Research.

[23]  C. Sagan,et al.  Pure flat epithelial atypia (DIN 1a) on core needle biopsy: study of 60 biopsies with follow-up surgical excision , 2010, Breast Cancer Research and Treatment.

[24]  R. Vierkant,et al.  Stratification of breast cancer risk in women with atypia: a Mayo cohort study. , 2007, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[25]  S. Schnitt,et al.  Columnar alteration with prominent apical snouts and secretions: a spectrum of changes frequently present in breast biopsies performed for microcalcifications. , 1998, The American journal of surgical pathology.

[26]  Romayne A. Thompson,et al.  Age-related lobular involution and risk of breast cancer. , 2006, Journal of the National Cancer Institute.

[27]  F. Bellafiore,et al.  Flat epithelial atypia with and without atypical ductal hyperplasia: to re-excise or not. Results of a 5-year prospective study , 2012, Virchows Archiv.

[28]  M. Hayes,et al.  Flat ductal intraepithelial neoplasia 1A diagnosed at stereotactic core needle biopsy: is excisional biopsy indicated? , 2013, AJR. American journal of roentgenology.

[29]  A. Adams.  Flat Epithelial Atypia: A Review of Current Concepts , 2014 .

[30]  E. Brogi,et al.  Atypical Cystic Lobules in Patients with Lobular Neoplasia , 2001, International journal of surgical pathology.

[31]  F. Tavassoli.  Ductal carcinoma in situ: introduction of the concept of ductal intraepithelial neoplasia. , 1998, Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc.

[32]  M. Martel,et al.  Flat DIN 1 (flat epithelial atypia) on core needle biopsy: 63 cases identified retrospectively among 1,751 core biopsies performed over an 8-year period (1992–1999) , 2007, Virchows Archiv.

[33]  S. Bianchi,et al.  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 , 2012, Virchows Archiv.

[34]  L. Fu,et al.  Clinicopathological characteristics of atypical cystic duct (ACD) of the breast: Assessment of ACD as a precancerous lesion , 2000, Zhonghua bing li xue za zhi = Chinese journal of pathology.

[35]  A. Vincent-Salomon,et al.  Epithelial atypia in biopsies performed for microcalcifications. Practical considerations about 2,833 serially sectioned surgical biopsies with a long follow-up , 2007, Virchows Archiv.