Atypical Apocrine Adenosis of the Breast: Long Term Follow-Up in 37 Patients.
Neil E Fuehrer, Lynn C Hartmann, Teresa M Allers, Robert A Vierkant, Marlene H Frost, Daniel W Visscher. Mayo Clinic, Rochester, MN
Background: Atypical apocrine adenosis (AAA) is an uncommon breast lesion in which the cellular population demonstrates cytological alterations that may be confused with apocrine DCIS. The clinical significance and management of AAA are unclear owing to lack of long term follow-up studies.
Design: We identified 37 AAA cases in the benign breast disease cohort at our institution which included 9340 women who had benign breast biopsies between 1967 and 1990. AAA was diagnosed during blinded pathology re-review performed by a single pathologist. Breast cancer diagnoses in the AAA patients subsequent to initial benign biopsy were then identified through questionnaires and multiple queries of computerized records (average 14 years of follow-up).
Results: Breast carcinoma subsequently developed in three women (8%) with AAA, diagnosed after follow up intervals of 4, 10 and 12 years. One of the three was contralateral to the original biopsy. The age at the time of diagnosis of AAA was 55, 47, and 63 years for those that developed subsequent carcinoma. The average age at diagnosis of AAA for all patients in the group was 59.3 years.
Conclusions: 1) AAA was a very uncommon lesion during the pre-needle core biopsy era, accounting for less than 1% of cases in our cohort. 2) AAA is diagnosed at an older age than other patients with benign breast disease. There does not appear to be an association with age and risk for developing carcinoma for patients diagnosed with AAA. 3) We found no evidence that AAA should be regarded as an aggressive lesion or unstable direct histological precursor to breast carcinoma.
Monday, February 28, 2011 1:00 PM
Poster Session II # 49, Monday Afternoon