title: Pure flat epithelial atypia: is there a place for routine surgery?
abstract: OBJECTIVE
  To determine whether it is appropriate to routinely undertake surgery if flat epithelial atypia (FEA) or pure flat epithelial atypia (pFEA) is found on large-core biopsy.
  
  
  METHODS
  Between 2005 and 2010, 1678 large-core biopsy procedures were carried out, which led to 136 FEA sites being identified, 63 of which across 59 patients were pFEA (four patients had two sites of pFEA each). Forty-eight patients underwent further surgical excision, equating to 52 excised sites of pFEA.
  
  
  RESULTS
  Of the 52 operated sites, there were 20 benign lesions (38%), 26 borderline lesions (56%), and three ductal carcinomas in situ (6%). The rate of histologic underestimation was put at 3.8%. Of the three cases that were underestimated, one was discarded because the definitive histology was not representative of the site from which microcalcifications had initially been taken. The other two cases that were underestimated were found in patients with an increased individual risk of breast cancer.
  
  
  CONCLUSIONS
  In patients with no personal or first-degree family history of breast cancer, after complete or subtotal excision under radiology of the radiological lesion, and while excluding images fitting BI-RADS 5, annual monitoring may be offered as an alternative to surgical excision in view of the absence of underestimation found in our study.
authors.affiliation: Département d'imagerie, centre Oscar-Lambret, 3, rue Frédéric-Combemale, BP 307, 59020 Lille cedex, France. Electronic address: l-ceugnart@o-lambret.fr.
authors.forename: L
authors.initials: L
authors.lastname: Ceugnart
authors.forename: V
authors.initials: V
authors.lastname: Doualliez
authors.forename: M-P
authors.initials: MP
authors.lastname: Chauvet
authors.forename: Y-M
authors.initials: YM
authors.lastname: Robin
authors.forename: F
authors.initials: F
authors.lastname: Bachelle
authors.forename: C
authors.initials: C
authors.lastname: Chaveron
authors.forename: N
authors.initials: N
authors.lastname: Rocourt
authors.forename: G
authors.initials: G
authors.lastname: Pouliquen
authors.forename: H
authors.initials: H
authors.lastname: Jarraya
authors.forename: S
authors.initials: S
authors.lastname: Taieb
mesh_terms: D000328:Adult; D000368:Aged; D062005:Biopsy, Large-Core Needle; D001940:Breast / Q000473:pathology; D001943:Breast Neoplasms / Q000235:genetics / Q000473:pathology* / Q000601:surgery*; D002114:Calcinosis / Q000473:pathology / Q000601:surgery; D002278:Carcinoma in Situ / Q000235:genetics / Q000473:pathology* / Q000601:surgery*; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000235:genetics / Q000473:pathology / Q000601:surgery; D003937:Diagnosis, Differential; D004847:Epithelial Cells / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D020022:Genetic Predisposition to Disease / Q000235:genetics; D006801:Humans; D008297:Male; D008327:Mammography; D015412:Mastectomy, Segmental; D008875:Middle Aged; D011230:Precancerous Conditions / Q000235:genetics / Q000473:pathology* / Q000601:surgery*; D011379:Prognosis
keywords: Borderline lesions; Breast cancer; Interventional