Epithelial atypia in biopsies performed for microcalcifications. practical considerations about 2,833 serially sectioned surgical biopsies with a long follow-up

Virchows Arch. 2007 Jul;451(1):1-10. doi: 10.1007/s00428-007-0408-5. Epub 2007 Jun 6.

Abstract

This study analyzes the occurrence of epithelial atypia in 2,833 serially sectioned surgical breast biopsies (SB) performed for microcalcifications (median number of blocks per SB:26) and the occurrence of subsequent cancer after an initial diagnosis of epithelial atypia (median follow-up 160 months). Epithelial atypia (flat epithelial atypia, atypical ductal hyperplasia, and lobular neoplasia) were found in 971 SB, with and without a concomitant cancer in 301 (31%) and 670 (69%) SB, respectively. Thus, isolated epithelial atypia were found in 670 out of the 2,833 SB (23%). Concomitant cancers corresponded to ductal carcinomas in situ and micro-invasive (77%), invasive ductal carcinomas not otherwise specified (15%), invasive lobular carcinomas (4%), and tubular carcinomas (4%). Fifteen out of the 443 patients with isolated epithelial atypia developed a subsequent ipsilateral (n = 14) and contralateral (n = 1) invasive cancer. The high slide rating might explain the high percentages of epithelial atypia and concomitant cancers and the low percentage of subsequent cancer after a diagnosis of epithelial atypia as a single lesion. Epithelial atypia could be more a risk marker of concomitant than subsequent cancer.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Biopsy
  • Breast / pathology*
  • Breast Neoplasms / pathology*
  • Calcinosis / pathology*
  • Carcinoma in Situ / pathology
  • Carcinoma, Ductal, Breast / pathology
  • Epithelium / pathology
  • Female
  • Follow-Up Studies
  • Humans
  • Hyperplasia
  • Middle Aged