Flat epithelial atypia and the risk of sampling error: Determining the value of excision after image-guided core-needle biopsy - 26/09/19
Abstract |
Background |
We determined the sampling error rate of flat epithelial atypia (FEA) and evaluated current guidelines recommending excisional biopsy.
Methods |
A retrospective review of consecutive excisional biopsies after image-guided core-needle biopsy identified patients with isolated FEA diagnosed between 2014 and 2018. Clinical and pathologic parameters were evaluated.
Results |
Twenty-five women with 27 biopsies were included. Based on pathologic review of original core specimens, 44.4% (N = 12) were accurately diagnosed as FEA. Upon excision, lesions were upgraded to ductal carcinoma in situ (N = 2) or invasive ductal carcinoma (N = 1) in 11.1% of cases. Older age, black race, hormone replacement, and calcifications in the image-guided biopsy specimen were associated with the presence of high-risk or malignant lesions in the excisional biopsy (all p ≤ 0.05).
Conclusions |
In this study, FEA was frequently overcalled. However, lesions suspicious for FEA warrant excision due to their association with malignancy or high-risk lesions, which may necessitate further surgical management and/or risk-reducing strategies.
Le texte complet de cet article est disponible en PDF.Highlights |
• | The diagnosis of flat epithelial atypia (FEA) by histologic examination varies between pathologists at a single institution. |
• | Diagnosis of FEA on core needle biopsy carries an 11.1% incidence of upgrade to malignancy on excision. |
• | Surgical excision of a site of FEA, per WHO criteria, is associated with a 25% incidence of upgrade to malignancy. |
Plan
Vol 218 - N° 4
P. 730-736 - octobre 2019 Retour au numéro
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