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Progression risk of columnar cell lesions of the breast diagnosed in core needle biopsies.
MedLine Citation:
PMID:  21225627     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Columnar cell lesions (CCLs) of the breast are recognized as putative precursor lesions of invasive carcinoma, but their management remains controversial. We therefore conducted a retrospective study on 311 CCLs, diagnosed in 4164 14-gauge core needle biopsies (CNB): 221 CCLs without atypia (CCL), 69 with atypia (CCL-A) and 21 atypical ductal hyperplasias originating in CCL (ADH-CCL). Two groups were identified: "immediate treatment" group undergoing excision within 4 months after the CNB diagnosis of CCL (N=52) and the "wait-and-see" group followed up to 8 years (median 3.5 years, N=259).In 7 of 31 women (22.5%, 1 CCL, 4 CCL-A, 2 ADH-CCL) that underwent immediate surgical excision and were initially biopsied for microcalcifications, ductal carcinoma in situ (DCIS) was present and in 2/31 women (6.5%, 1 CCL, 1 CCL-A) invasive carcinoma. In 2/21 excisions (9.5%, 1 CCL, 1 CCL-A) initially biopsied for a density, DCIS was present and invasive carcinoma in 5/21 excisions (23.8%, 2 CCL, 3 CCL-A). In the wait-and-see group, 9/259 women (3.5%) developed invasive carcinoma, 6 ipsi- and 3 contralaterally. Progression risks of CCL-A and ADH-CCL were 18% and 22%, versus 2% for CCL without atypia (p<0.001).In conclusion, CCL-A or ADH-CCL in a CNB were associated with a high risk of DCIS/invasive carcinoma in immediate surgical excision biopsies. The 8-years progression risks for CCL-A and ADH-CCL were around 20%. This illustrates that an atypical CCL in a CNB may signal the presence of concurrent lesions or development of advanced lesions in future and may justify ('mini') surgical excision.
Authors:
Anoek Hj Verschuur-Maes; Arjen J Witkamp; Peter C de Bruin; Elsken van der Wall; Paul J van Diest
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-1-10
Journal Detail:
Title:  International journal of cancer. Journal international du cancer     Volume:  -     ISSN:  1097-0215     ISO Abbreviation:  -     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2011-1-12     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0042124     Medline TA:  Int J Cancer     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Departments of Pathology, St. Antonius Ziekenhuis Nieuwegein, The Netherlands.
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