Flat Ductal Intraepithelial Neoplasia 1 (Flat Epithelial Atypia) in Core Needle Biopsy: What Do We Do?
T Milless, N Buza, F Tavassoli, V Bossuyt. Yale University, New Haven
Background: Flat ductal intraepithelial neoplasia 1 (flat DIN1) or flat epithelial atypia (FEA) is a frequent finding in breast core needle biopsies (CNB) particularly those performed for calcifications. The clinical significance and management of flat DIN1(FEA) in CNB is a topic of widespread debate. Our study evaluates the utility of performing additional levels when flat DIN1 (FEA) is present as the most advanced lesion on CNB as proposed previously by one of the authors.
Design: The pathology reports of 1000 CNB at our institution during a 5-year period (2004-2009) included a diagnosis of flat DIN1 (FEA). The presence of concurrent lesions and whether or not levels were examined was noted. Slides from those cases with flat DIN1 (FEA) and AIDH for which levels had been examined were reviewed to determine whether the AIDH was present on the original sections or if it appeared only after evaluation of additional levels.
Results: AIDH was present in 361 (36.1%) of 1000 CNB with flat DIN1 (FEA). Other lesions identified included LIN in 12.1% of the CNB, papillary lesions (in 8.3%), invasive carcinoma (in 6.1%).
Additional levels were examined in 279 of 1000 CNB. Of the 361 CNB with concommitant AIDH levels were examined in 78. AIDH was only present on the additional levels (but not the original levels) in 34 (9.4%) of the CNB.
Examining additional levels when flat DIN1 (FEA) is present as the most advanced lesion on CNB led to approximately a 10% increase in detection of AIDH.
Conclusions: Performing additional levels when flat DIN1 (FEA) is present as the most advanced lesion on CNB leads to a significant increase in detection of lesions warranting an exisional biopsy.
Wednesday, March 24, 2010 9:30 AM
Poster Session V # 35, Wednesday Morning