Flat Epithelial Atypia (FEA) Is a Common Subtype of B3 Breast Lesions and Associated with Non-Invasive Cancer but Not with Invasive Cancer in Final Excision Histology
A Noske, S Pahl, C Richter-Ehrenstein, E Fallenberg, AC Buckendahl, C Denkert. Universitätsspital Zurich, Zurich, Switzerland; Charité, Berlin, Germany
Background: The biological behaviour and the optimal management of benign breast lesions with uncertain malignant potential, the so called B3 lesions, found in breast needle core biopsies is still under debate. We addressed this study to compare histological findings in B3 needle core biopsies with final excision specimens to determine associated rates of malignancy.
Design: Consecutive needle core biopsies (NCB) were performed in a three-year period (01.01.2006-31.12.2008). Biopsies were image-guided (31 by ultrasound, 85 stereotactic vacuum-assisted, 6 unknown) for evaluation of breast abnormalities. We reviewed 122 NCB B3 lesions of 91 symptomatic patients and 31 screen-detected women and compared the B3 histological subtypes with the final excision histology.
Results: A total of 1845 NCBs were performed and B3 lesions comprised 6.6% of all B-categories. The most common histological subtype in B3-NCBs was flat epithelia atypia (FEA) in 35.2%, followed by papillary lesions in 21%, and atypical ductal hyperplasia (ADH) in 20%. Reports on excision specimens were available in 66% (81 patients). Final excision histology was benign in 73 (90.2%) and malignant in 8 (9.8%) patients (2 invasive cancer, 6 ductal carcinoma in situ). Of all B3 subtypes, only ADH and FEA were associated with malignancy, whereas only ADH was accompanied by invasive cancer. Of all lesions, FEA was most frequently found in excision specimens (18%).
Conclusions: FEA and ADH are common lesions of the B3-category in needle core biopsies of the breast. Both lesions are associated with malignancy whereas only ADH was related to invasive cancer. Depending on clinical and radiological findings, we conclude that an excision biopsy after diagnosis of FEA is recommended.
Monday, March 22, 2010 1:00 PM
Poster Session II # 33, Monday Afternoon