Columnar Cell Lesions of the Breast: Association with Other Types of Fibrocystic Change and Distribution in Hispanic and Non-Hispanic White Women
L Lomo, M Myrsiades, A Nibbe, T Bocklage, D Hill. University of New Mexico School of Medicine, Albuquerque, NM
Background: Columnar cell lesions encompass a spectrum including columnar cell change, columnar cell hyperplasia, flat epithelial atypia and micropapillary DCIS. Known for many years under different names, this group of lesions is linked by a similar cytomorphology and reactivity pattern to HMW keratins. Relatively few studies have examined the association of columnar cell lesions with ethnicity and with other types of fibrocystic change. We evaluated 286 breast benign biopsies that were initially diagnosed as non-proliferative, proliferative without atypia, or atypical hyperplasia to review the frequency of columnar cell lesions and association with other fibrocystic changes.
Design: Three pathologists reviewed 286 breast biopsies culled from 14,792 women with benign breast biopsy diagnoses rendered in 1996-2007 in New Mexico. Five year follow-up was available. Thirty parameters were evaluated histologically and entered into an Access database. The pathologists used criteria of Schnitt and Collins to classify fibrocystic changes including columnar cell lesions. Ethnicity and patient age were obtained. Statistical analysis was completed by a statistician. The pathologists were blinded to patient outcome, and interobserver variability was assessed.
Results: Age ranged from 30 to 87 (mean of 55 years). Of the 149 white Non-Hispanic women selected for the study, 66 (44%) had columnar lesions, and of the 58 Hispanic women, 29 (50%) had columnar lesions (79 patients had unknown ethnicity). Columnar cell changes were unifocal in 36 percent and multifocal (more than two blocks positive) in 45% of patients. Columnar cell hyperplasia was more often multifocal than columnar cell change. Two patients had flat epithelial atypia. For the period 1996-2007 in this cohort, there were no significant differences in frequency of columnar cell lesions in Non-Hispanic and Hispanic white women. Chi-square analysis was performed and showed a statistically significant positive association of columnar cell lesions with usual ductal hyperplasia, sclerosing adenosis, and apocrine metaplasia (p value < 0.0001).
Conclusions: In this initial study, the incidence of columnar cell lesions appeared similar in recently diagnosed Hispanic and Non-Hispanic white women. A strong positive association was noted between columnar cell lesions and other specific fibrocystic changes. The large number of columnar cell change and hyperplasia contrasted with a rare diagnosis of flat epithelial atypia.
Monday, March 22, 2010 1:00 PM
Poster Session II # 35, Monday Afternoon