Aims and objectives
The development of mammographic screening programs has led to a considerable increase in the number of biopsies performed for subclinical mammographic abnormalities,
As a consequence,
a diagnosis of ” flat epithelial atypia” (FEA) is increasingly frequent.
FEA is not a new entity.
It was described in 1979 as a distinctive intraepithelial neoplastic lesion breast lesion,
which was named “clinging carcinoma in situ” (1).
it has received a wide variety of appellations such as “atypical ductal cells with apocrine snouts”,
Methods and materials
We reviewed our database of all stereotactically (n=724) and sonographically (n=521) vacuum assisted biopsy procedures performed in our hospital between January 2007 and December 2010.
We included in the study 45 lesions (45 patients) biopsied under stereotactic (n=34) and sonographic (n=11) VAB guidance in which FEA was the most advanced lesion at pathologic examination.
All 45 patients underwent surgical excision (n=27) or a minimum of 2 years´ imaging follow-up (n=18).
The patient´s age,
personal history of breast cancer,
clinical presentation (if the lesion...
Of the 1245 vacuum-assisted biopsies,
45 yielded FEA (3.6 %).
Thirty-four of 45 FEA were obtained under stereotactic guidance (75 %) and 11 under sonographic guidance (25 %).
The average patient age was 49 years (range,
FEA was found during the staging of a synchronous cancer in the same breast in two patients.
One patient had a history of previous cancer in the contralateral breast.
Six patients had familial history of breast cancer.
Six of the 45 lesions were palpable....
In this study of 45 vacuum-biopsied FEA,
the underestimation rate was 6.7 % (3/45).
We conclude that a diagnosis of FEA with vacuum-assisted biopsy requires surgical excision,
but the size of the lesion and the percentage of microcalcifications removed may be helpful in predicting the possibility of upgrade to malignancy.
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