Incidence of Columnar Cell Lesions in the NSABP B-17 Lobular Neoplasia Patients, Using Digitized Images.
Joseph W Byers, Michael L Cibull, Sujin Kim, Brill Yolanda, Luis M Samayoa. University of Kentucky, Lexington; VAMC, Lexington, KY; Instituto Internacional de Cancer, San Salvador, El Salvador
Background: The significance of Columnar Cell Lesions (CCL) remains controversial. While molecular links between atypical CCL, Atypical Hyperplasias (AH) and low grade invasive and in-situ carcinomas strongly suggest a precursor role, these alterations could also represent a co-occurrence phenomenon, specifically in patients with Lobular Neoplasia (NL).
Design: Digitized slides from 216 patients with LN were reviewed for the following: Columnar Cell Changes without (w/o) hyperplasia or atypia (CCC); Columnar Cell Changes + Hyperplasia with and w/o Atypia (CCCH and CCCHA respectively) and Columnar Cell Change with Atypia (CCCA) or Flat Epithelial Atypia and other Fibrocystic Changes (FCC). CCL and LN diagnoses were made according to the criteria of Schnitt and Vincent-Salomon and Page. Slides were scanned at 4X for LN. The surrounding area was then examined at 20X for CCL and if not identified, the remainder of the slide was scanned at 4X and 20X. Cytologic atypia was analyzed at 40X. Distance between CCL and LN was measured in mm. A total of 1526 fields were examined. The incidence of each diagnosis was recorded and submitted for statistical analysis.
Conclusions: While the presence of CCL in LN (predominantly ALH) appears to be significantly increased (p < 0.01), the incidence of CCL + Atypia was similar to other proliferative FCC such as FUH and SA. These findings are in agreement with those reported by Page et al* for the general population, conferring CCL + Atypia a relative risk for subsequent carcinoma similar to epithelial hyperplasia lacking atypia and suggesting a co-occurrence phenomenon (54% of CCL within 1mm of LN) rather than a precursor role for these lesions.
Monday, February 28, 2011 1:00 PM
Poster Session II # 36, Monday Afternoon