title: Columnar cell lesions associated with breast calcifications on vacuum-assisted core biopsies: clinical, radiographic, and histological correlations.
abstract: Columnar cell lesions of the breast are increasingly recognized at mammography for their tendency to calcify. We studied 392 vacuum-assisted core biopsies performed solely for calcifications to evaluate the frequency of columnar cell lesions, their relationship with radiological risk, appearance of calcifications, and clinical data. Management and follow-up of columnar cell lesions without and with atypia (flat epithelial atypia) was analyzed. Cases with architectural atypia (cribriform spaces and/or micropapillae) were excluded from flat epithelial atypia. Calcifications were within the lumen of acini affected by columnar cell lesions in 137 out of 156 biopsies diagnosed with some columnar cell lesions. These represented 37% of vacuum-assisted core biopsies and 62% of low radiological risk (BI-RADS3) calcifications. High-risk (BI-RADS5) calcifications were never associated with columnar cell lesions. Age and menopausal status were comparable in columnar and in not-columnar cell lesions. Atypia was associated with long-term hormone replacement therapy in both lesions. Surgical biopsy was recommended for all cases with atypia. Flat epithelial atypia, as the only histological findings on vacuum-assisted core biopsies, was never associated with malignancy at surgery. In conclusion, we suggest that surgical excision is not mandatory when flat epithelial atypia is found as the most advanced lesion on vacuum-assisted core biopsy performed for low radiological risk calcifications, and that women should be advised of the possible hormone dependency of this entity.
authors.affiliation: Department of Biomedical Sciences and Human Oncology, University of Turin, Turin, Italy.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Senetta
authors.forename: Pier Paolo
authors.initials: PP
authors.lastname: Campanino
authors.forename: Giovanna
authors.initials: G
authors.lastname: Mariscotti
authors.forename: Sara
authors.initials: S
authors.lastname: Garberoglio
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Daniele
authors.forename: Francesca
authors.initials: F
authors.lastname: Pennecchi
authors.forename: Luigia
authors.initials: L
authors.lastname: Macrì
authors.forename: Martino
authors.initials: M
authors.lastname: Bosco
authors.forename: Giovanni
authors.initials: G
authors.lastname: Gandini
authors.forename: Anna
authors.initials: A
authors.lastname: Sapino
mesh_terms: D001706:Biopsy; D001707:Biopsy, Needle; D001941:Breast Diseases / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D002114:Calcinosis / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D008327:Mammography; D011230:Precancerous Conditions / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D012307:Risk Factors