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Pure flat epithelial atypia (DIN 1a) on core needle biopsy: study of 60 biopsies with follow-up surgical excision.
Breast Cancer Res Treat. 2011 Jan; 125(1):121-6.BC

Abstract

Flat epithelial atypia (FEA) is recognized as a precursor of breast cancer and its management (surgical excision or intensive follow-up) remains unclear after diagnosis on core needle biopsy (CNB). The aim of this study was to determine the underestimation rate of pure FEA on CNB and clinical, radiological, and pathological factors of underestimation. 4,062 CNBs from 5 breast cancer centers, performed over a 5-year period, were evaluated. A CNB diagnosis of pure FEA was made in 60 cases (1.5%) (the presence of atypical ductal hyperplasia, lobular neoplasia, radial scars, phyllodes tumor, papillary lesions, ductal carcinoma in situ or invasive carcinoma at CNB were exclusion criteria), and subsequent surgical excision was systematically performed. The histological diagnosis was retrospectively reviewed using standardized criteria and the precise terminology of the World Health Organization by two pathologist physicians. At surgical excision, 6 (10%) ductal carcinoma in situ and 2 (3%) invasive carcinoma were diagnosed. The total underestimation rate was 13%. FEA was associated with atypical ductal hyperplasia in 10 (17%) cases and with lobular neoplasia in 2 (3%) at final pathology. Residual FEA was found in 14 (23%) cases. No clinical, radiological or pathological factors were significantly associated with underestimation. Our data highlight the importance of recognizing and diagnosing FEA in core needle biopsies. Thus, the presence of FEA on CNB, even in isolation, warrants follow-up excision.

Authors+Show Affiliations

Eugène Marquis Comprehensive Cancer Center, Rennes, France.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study

Language

eng

PubMed ID

20945087

Citation

Lavoué, Vincent, et al. "Pure Flat Epithelial Atypia (DIN 1a) On Core Needle Biopsy: Study of 60 Biopsies With Follow-up Surgical Excision." Breast Cancer Research and Treatment, vol. 125, no. 1, 2011, pp. 121-6.
Lavoué V, Roger CM, Poilblanc M, et al. Pure flat epithelial atypia (DIN 1a) on core needle biopsy: study of 60 biopsies with follow-up surgical excision. Breast Cancer Res Treat. 2011;125(1):121-6.
Lavoué, V., Roger, C. M., Poilblanc, M., Proust, N., Monghal-Verge, C., Sagan, C., Tas, P., Mesbah, H., Porée, P., Gay, C., Body, G., & Levêque, J. (2011). Pure flat epithelial atypia (DIN 1a) on core needle biopsy: study of 60 biopsies with follow-up surgical excision. Breast Cancer Research and Treatment, 125(1), 121-6. https://doi.org/10.1007/s10549-010-1208-1
Lavoué V, et al. Pure Flat Epithelial Atypia (DIN 1a) On Core Needle Biopsy: Study of 60 Biopsies With Follow-up Surgical Excision. Breast Cancer Res Treat. 2011;125(1):121-6. PubMed PMID: 20945087.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Pure flat epithelial atypia (DIN 1a) on core needle biopsy: study of 60 biopsies with follow-up surgical excision. AU - Lavoué,Vincent, AU - Roger,Claire Marie, AU - Poilblanc,Mathieu, AU - Proust,Nicolas, AU - Monghal-Verge,Camille, AU - Sagan,Christine, AU - Tas,Patrick, AU - Mesbah,Habiba, AU - Porée,Philippe, AU - Gay,Catherine, AU - Body,Gilles, AU - Levêque,Jean, Y1 - 2010/10/14/ PY - 2010/07/29/received PY - 2010/09/29/accepted PY - 2010/10/15/entrez PY - 2010/10/15/pubmed PY - 2011/3/22/medline SP - 121 EP - 6 JF - Breast cancer research and treatment JO - Breast Cancer Res Treat VL - 125 IS - 1 N2 - Flat epithelial atypia (FEA) is recognized as a precursor of breast cancer and its management (surgical excision or intensive follow-up) remains unclear after diagnosis on core needle biopsy (CNB). The aim of this study was to determine the underestimation rate of pure FEA on CNB and clinical, radiological, and pathological factors of underestimation. 4,062 CNBs from 5 breast cancer centers, performed over a 5-year period, were evaluated. A CNB diagnosis of pure FEA was made in 60 cases (1.5%) (the presence of atypical ductal hyperplasia, lobular neoplasia, radial scars, phyllodes tumor, papillary lesions, ductal carcinoma in situ or invasive carcinoma at CNB were exclusion criteria), and subsequent surgical excision was systematically performed. The histological diagnosis was retrospectively reviewed using standardized criteria and the precise terminology of the World Health Organization by two pathologist physicians. At surgical excision, 6 (10%) ductal carcinoma in situ and 2 (3%) invasive carcinoma were diagnosed. The total underestimation rate was 13%. FEA was associated with atypical ductal hyperplasia in 10 (17%) cases and with lobular neoplasia in 2 (3%) at final pathology. Residual FEA was found in 14 (23%) cases. No clinical, radiological or pathological factors were significantly associated with underestimation. Our data highlight the importance of recognizing and diagnosing FEA in core needle biopsies. Thus, the presence of FEA on CNB, even in isolation, warrants follow-up excision. SN - 1573-7217 UR - https://www.unboundmedicine.com/medline/citation/20945087/Pure_flat_epithelial_atypia__DIN_1a__on_core_needle_biopsy:_study_of_60_biopsies_with_follow_up_surgical_excision_ L2 - https://doi.org/10.1007/s10549-010-1208-1 DB - PRIME DP - Unbound Medicine ER -