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Flat epithelial atypia on core needle biopsy, must we surgically excise?
Am J Surg. 2016 Dec; 212(6):1211-1213.AJ

Abstract

Breast flat epithelial atypia (FEA) often coexists with more aggressive pathology and excision is currently recommended when diagnosed by core needle biopsy (CNB). Recent studies suggest isolated FEA has a low association with carcinoma and may warrant close surveillance. A radiology database containing 2189 breast CNB was reviewed for isolated FEA or FEA in combination with atypical pathology. 79 patients had FEA. There were 48/79 with isolated FEA and 31/79 concomitant FEA with ADH, ALH, or LCIS. 46 subsequent excisional biopsies of isolated FEA resulted: benign 38/46, ADH 5/46, LCIS 2/46, DCIS 1/46. Concomitant FEA + ADH/ALH/LCIS group resulted: benign 26/31, DCIS 3/31, DCIS and LCIS 1/31, tubular carcinoma 1/31. DCIS/invasive cancer on excision in the FEA + ADH group is 5/31 versus 1/46 for isolated FEA (p 0.0489). Findings support literature suggesting isolated FEA has a low association with carcinoma. These patients may not require surgical excision, but instead have close surveillance. Based on the higher cancer incidence in FEA combined with ADH, ALH, LCIS, or residual microcalcifications, we still recommend surgical excision.

SUMMARY

Breast flat epithelial atypia (FEA) often coexists with more aggressive pathology and surgical excision is currently recommended when diagnosed by core needle biopsy. Recent studies have suggested isolated FEA has a low association with carcinoma and these patients may warrant close surveillance. Isolated FEA has a low association with carcinoma in our series. These patients may not require surgical excision, but instead have close surveillance.

Authors+Show Affiliations

Central Arkansas Veterans Healthcare Administration, Little Rock, AR, USA. Electronic address: alisonacott@gmail.com.Central Arkansas Veterans Healthcare Administration, Little Rock, AR, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27832842

Citation

Acott, A A., and A T. Mancino. "Flat Epithelial Atypia On Core Needle Biopsy, Must We Surgically Excise?" American Journal of Surgery, vol. 212, no. 6, 2016, pp. 1211-1213.
Acott AA, Mancino AT. Flat epithelial atypia on core needle biopsy, must we surgically excise? Am J Surg. 2016;212(6):1211-1213.
Acott, A. A., & Mancino, A. T. (2016). Flat epithelial atypia on core needle biopsy, must we surgically excise? American Journal of Surgery, 212(6), 1211-1213. https://doi.org/10.1016/j.amjsurg.2016.09.019
Acott AA, Mancino AT. Flat Epithelial Atypia On Core Needle Biopsy, Must We Surgically Excise. Am J Surg. 2016;212(6):1211-1213. PubMed PMID: 27832842.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Flat epithelial atypia on core needle biopsy, must we surgically excise? AU - Acott,A A, AU - Mancino,A T, Y1 - 2016/10/29/ PY - 2016/03/19/received PY - 2016/09/06/revised PY - 2016/09/06/accepted PY - 2016/11/12/pubmed PY - 2017/3/28/medline PY - 2016/11/12/entrez KW - Breast KW - Core needle biopsy KW - Flat epithelial atypia KW - Surgical excision SP - 1211 EP - 1213 JF - American journal of surgery JO - Am J Surg VL - 212 IS - 6 N2 - : Breast flat epithelial atypia (FEA) often coexists with more aggressive pathology and excision is currently recommended when diagnosed by core needle biopsy (CNB). Recent studies suggest isolated FEA has a low association with carcinoma and may warrant close surveillance. A radiology database containing 2189 breast CNB was reviewed for isolated FEA or FEA in combination with atypical pathology. 79 patients had FEA. There were 48/79 with isolated FEA and 31/79 concomitant FEA with ADH, ALH, or LCIS. 46 subsequent excisional biopsies of isolated FEA resulted: benign 38/46, ADH 5/46, LCIS 2/46, DCIS 1/46. Concomitant FEA + ADH/ALH/LCIS group resulted: benign 26/31, DCIS 3/31, DCIS and LCIS 1/31, tubular carcinoma 1/31. DCIS/invasive cancer on excision in the FEA + ADH group is 5/31 versus 1/46 for isolated FEA (p 0.0489). Findings support literature suggesting isolated FEA has a low association with carcinoma. These patients may not require surgical excision, but instead have close surveillance. Based on the higher cancer incidence in FEA combined with ADH, ALH, LCIS, or residual microcalcifications, we still recommend surgical excision. SUMMARY: Breast flat epithelial atypia (FEA) often coexists with more aggressive pathology and surgical excision is currently recommended when diagnosed by core needle biopsy. Recent studies have suggested isolated FEA has a low association with carcinoma and these patients may warrant close surveillance. Isolated FEA has a low association with carcinoma in our series. These patients may not require surgical excision, but instead have close surveillance. SN - 1879-1883 UR - https://www.unboundmedicine.com/medline/citation/27832842/Flat_epithelial_atypia_on_core_needle_biopsy_must_we_surgically_excise L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9610(16)30568-2 DB - PRIME DP - Unbound Medicine ER -