Breast Cancer Risk in Women with Diagnosis of Flat Epithelial Atypia: Follow-Up Study in a Benign Breast Disease Cohort.
Aziza Nassar, Sonia Narendra, Carol A Reynolds, Robert A Vierkant, Marlene Frost, Lynn C Hartmann, Daniel W Visscher. Mayo Clinic, Rochester, MN
Background: Atypical columnar lesions or flat epithelial atypia (FEA) have been noted to accompany ADH, DCIS or invasive cancers, implying that they represent high risk index lesions. However, the future risk association for breast cancer has yet to be studied in multiple cohorts. This study was undertaken to assess the risk for subsequent breast cancer in a group of women with FEA identified in a retrospective cohort of women with benign breast disease (BBD)
Design: Columnar cell lesions (CCLs) were assessed in 9087 women in the BBD Cohort who underwent excisional breast biopsy between 1967-1991. CCLs were further classified into columnar cell change, columnar cell hyperplasia and FEA. Development of breast cancer, laterality, age and time to follow-up was extracted from the database.
Results: CCLs were identified in 2025 (22%) of BBD subjects. FEA was detected in 99 cases (4.9% of the CCLs group) with an overall cohort frequency of 1.1% (99/9087). Median age at time of benign biopsy was 46.4 years (range 21.8 to 73.3 years). Out of 99 patients, 17 had no follow-up (last follow-up was at time of benign biopsy). Breast cancer was detected in follow up of 15.1% of FEA cases. Of the 15 women who did develop breast cancer, this occurred from 2.7 years to 31 years from time of benign biopsy (median time to cancer was 12.8 years). 11 out of 15 cancers occurred on the same side as the benign biopsy.
Conclusions: The data suggest that women with FEA are at increased risk for breast cancer although we cannot be certain based on these data only due to lack of appropriate control cases for comparison. Based on these limited data, follow-up excisional biopsy is recommended for women with a diagnosis of FEA.
Monday, February 28, 2011 11:30 AM
Platform Session: Section C, Monday Morning