Epithelial atypia in biopsies performed for microcalcifications. practical considerations about 2,833 serially sectioned surgical biopsies with a long follow-up.
This study analyzes the occurrence of epithelial atypia in 2,833 serially sectioned surgical breast biopsies (SB) performed for microcalcifications (median number of blocks per SB:26) and the occurrence of subsequent cancer after an initial diagnosis of epithelial atypia (median follow-up 160 months). Epithelial atypia (flat epithelial atypia, atypical ductal hyperplasia, and lobular neoplasia) were found in 971 SB, with and without a concomitant cancer in 301 (31%) and 670 (69%) SB, respectively. Thus, isolated epithelial atypia were found in 670 out of the 2,833 SB (23%). Concomitant cancers corresponded to ductal carcinomas in situ and micro-invasive (77%), invasive ductal carcinomas not otherwise specified (15%), invasive lobular carcinomas (4%), and tubular carcinomas (4%). Fifteen out of the 443 patients with isolated epithelial atypia developed a subsequent ipsilateral (n = 14) and contralateral (n = 1) invasive cancer. The high slide rating might explain the high percentages of epithelial atypia and concomitant cancers and the low percentage of subsequent cancer after a diagnosis of epithelial atypia as a single lesion. Epithelial atypia could be more a risk marker of concomitant than subsequent cancer.
de Mascarel
Isabelle
I
Department of Pathology, Institut Bergonié, Regional Cancer Center, Bordeaux, France. mascarel@bergonie.org
MacGrogan
Gaëtan
G
Mathoulin-Pélissier
Simone
S
Vincent-Salomon
Anne
A
Soubeyran
Isabelle
I
Picot
Véronique
V
Coindre
Jean-Michel
JM
Mauriac
Louis
L
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D001940:Breast / Q000473:pathology*; D001943:Breast Neoplasms / Q000473:pathology*; D002114:Calcinosis / Q000473:pathology*; D002278:Carcinoma in Situ / Q000473:pathology; D018270:Carcinoma, Ductal, Breast / Q000473:pathology; D004848:Epithelium / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006965:Hyperplasia; D008875:Middle Aged