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Flat epithelial atypia on core needle biopsy: which is the right management?
Am J Surg Pathol. 2009 Jul; 33(7):1078-84.AJ

Abstract

The clinical significance and management (surgical excision vs. follow-up) of the patients with the diagnosis of flat epithelial atypia (FEA) on core needle biopsy (CNB) are actually under discussion. Using standardized criteria and precise terminology, we analyzed retrospectively our CNB diagnosis of FEA, dividing patients with pure FEA as the most advanced pathologic lesion from patients with FEA associated to atypical ductal hyperplasia (FEA+ADH). Both the categories were correlated with radiologic data and findings on subsequent surgery. We evaluated 875 core needle biopsies (11-gauge stereotactic vacuum-assisted procedure), performed over a 5-year period. A CNB diagnosis of pure FEA was made in 33/875 (3.7%) cases; in other 11 (1.2%) cases we observed the coexistence of FEA and ADH. Subsequent surgical excisions were available in 20/33 pure FEA and in 10/11 FEA+ADH: of the 20 patients with pure FEA on CNB, none had either ductal carcinoma in situ or invasive carcinoma in their excisional biopsy, whereas 3/10 (30%) FEA+ADH on CNB showed, at subsequent surgery, more advanced lesions (2 ductal carcinoma in situ, 1 invasive carcinoma). Our results suggest that patients with an 11-gauge vacuum-assisted CNB diagnosis of pure FEA (especially if related to a small radiologic target, completely or almost completely removed by the needle biopsy procedure) could be spared surgical excision and managed with close radiologic follow-up.

Authors+Show Affiliations

Division of Pathology, Azienda Ospedaliera di Verona, piazzale Stefani 1, Verona 37126, Italy. quirino.piubello@azosp.vr.itNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Historical Article
Journal Article

Language

eng

PubMed ID

19390424

Citation

Piubello, Quirino, et al. "Flat Epithelial Atypia On Core Needle Biopsy: Which Is the Right Management?" The American Journal of Surgical Pathology, vol. 33, no. 7, 2009, pp. 1078-84.
Piubello Q, Parisi A, Eccher A, et al. Flat epithelial atypia on core needle biopsy: which is the right management? Am J Surg Pathol. 2009;33(7):1078-84.
Piubello, Q., Parisi, A., Eccher, A., Barbazeni, G., Franchini, Z., & Iannucci, A. (2009). Flat epithelial atypia on core needle biopsy: which is the right management? The American Journal of Surgical Pathology, 33(7), 1078-84. https://doi.org/10.1097/PAS.0b013e31819d0a4d
Piubello Q, et al. Flat Epithelial Atypia On Core Needle Biopsy: Which Is the Right Management. Am J Surg Pathol. 2009;33(7):1078-84. PubMed PMID: 19390424.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Flat epithelial atypia on core needle biopsy: which is the right management? AU - Piubello,Quirino, AU - Parisi,Alice, AU - Eccher,Albino, AU - Barbazeni,Giovanna, AU - Franchini,Zeno, AU - Iannucci,Antonio, PY - 2009/4/25/entrez PY - 2009/4/25/pubmed PY - 2010/2/3/medline SP - 1078 EP - 84 JF - The American journal of surgical pathology JO - Am J Surg Pathol VL - 33 IS - 7 N2 - The clinical significance and management (surgical excision vs. follow-up) of the patients with the diagnosis of flat epithelial atypia (FEA) on core needle biopsy (CNB) are actually under discussion. Using standardized criteria and precise terminology, we analyzed retrospectively our CNB diagnosis of FEA, dividing patients with pure FEA as the most advanced pathologic lesion from patients with FEA associated to atypical ductal hyperplasia (FEA+ADH). Both the categories were correlated with radiologic data and findings on subsequent surgery. We evaluated 875 core needle biopsies (11-gauge stereotactic vacuum-assisted procedure), performed over a 5-year period. A CNB diagnosis of pure FEA was made in 33/875 (3.7%) cases; in other 11 (1.2%) cases we observed the coexistence of FEA and ADH. Subsequent surgical excisions were available in 20/33 pure FEA and in 10/11 FEA+ADH: of the 20 patients with pure FEA on CNB, none had either ductal carcinoma in situ or invasive carcinoma in their excisional biopsy, whereas 3/10 (30%) FEA+ADH on CNB showed, at subsequent surgery, more advanced lesions (2 ductal carcinoma in situ, 1 invasive carcinoma). Our results suggest that patients with an 11-gauge vacuum-assisted CNB diagnosis of pure FEA (especially if related to a small radiologic target, completely or almost completely removed by the needle biopsy procedure) could be spared surgical excision and managed with close radiologic follow-up. SN - 1532-0979 UR - https://www.unboundmedicine.com/medline/citation/19390424/Flat_epithelial_atypia_on_core_needle_biopsy:_which_is_the_right_management DB - PRIME DP - Unbound Medicine ER -