A rare and unusual cause of mammographic calcification in the breast

2016 ◽  
Vol 70 (1) ◽  
pp. 89-89 ◽  
Author(s):  
Andrew Robinson ◽  
Abeer M Shaaban
Keyword(s):  
Family History ◽  
Parasitic Infection ◽  
Flat Epithelial Atypia ◽  
List Type ◽  
Clinical Question ◽  
Digital Slide ◽  
Outer Quadrant ◽  
Liesegang Rings ◽  
Mammotome Biopsy ◽  
Epithelial Atypia

Clinical questionA 45-year-old woman is found, on family history screening, to have calcification within the upper outer quadrant of her right breast. A diagnostic mammotome biopsy was performed. Review the interactive digital slide and consider your diagnosis and appropriate management.What is your diagnosis?Collagenous spherulosisFlat epithelial atypia with psammomatous calcificationLiesegang rings with lactational changesParasitic infectionSpheroid type amyloid

scholarly journals Upgrade Rate of Flat Epithelial Atypia Diagnosed at Stereotactic Core Needle Biopsy of Microcalcifications: Is Excisional Biopsy Indicated?

2020 ◽  
Vol 2 (4) ◽  
pp. 336-342
Author(s):  
Paula B Gordon ◽  
Emma Branch
Keyword(s):  
Family History ◽  
High Risk ◽  
Surgical Excision ◽  
Excisional Biopsy ◽  
Flat Epithelial Atypia ◽  
High Risk Lesion ◽  
History Of ◽  
Epithelial Atypia

Abstract Objective Whether the optimal management of pure flat epithelial atypia (FEA) found on core needle biopsy (CNB) specimens is surgical excision or imaging follow-up remains controversial. This study aimed to determine the upgrade rate to ductal carcinoma in situ (DCIS), invasive carcinoma or a high-risk lesion (atypical ductal hyperplasia, atypical lobular hyperplasia, or lobular carcinoma in situ), and it explored the relationship between a family history of breast cancer and the risk of upgrade. Methods Cases with pure FEA found on stereotactic CNB of microcalcifications between March 2011 to December 2017 were followed by excisional biopsy or periodic imaging. The proportion of cases upgraded to a high-risk lesion and the odds of upgrade as related to a family history of breast cancer were determined with 95% confidence intervals (CIs). Results We identified 622 cases of pure FEA; 101 (16.2%) underwent surgical excision and 269 (43.2%) had imaging follow-up of ≥ 24 months. There were no upgrades to DCIS or invasive cancer in any of these 370 individuals (0%), and 4.6% (17/370; 95% CI: 2.9%–7.2%) were upgraded to a high-risk lesion. There was a nonstatistically significant trend between family history and upgrade to high-risk lesion (odds ratio 1.72 [95% CI: 0.65%–4.57%]). Conclusion In our study, the upgrade rate of pure FEA to malignancy was 0%. We suggest that regular imaging follow-up is an appropriate alternative to surgery. Because of potential differences in biopsy techniques and pathologist interpretation of the primary biopsy, individual institutions should audit their own results prior to altering their management of FEA.

Majority of flat epithelial atypia diagnosed on biopsy do not require surgical excision

The Breast ◽  
2018 ◽  
Vol 37 ◽  
pp. 13-17 ◽  
Author(s):  
Patrick Mun Yew Chan ◽  
Niketa Chotai ◽  
Eileen Shujuan Lai ◽  
Pei Yi Sin ◽  
Juliana Chen ◽  
...  
Keyword(s):  
Surgical Excision ◽  
Flat Epithelial Atypia ◽  
Epithelial Atypia

Transitions Between Flat Epithelial Atypia and Low-grade Ductal Carcinoma In Situ of the Breast

2012 ◽  
Vol 36 (8) ◽  
pp. 1247-1252 ◽  
Author(s):  
Sebastian Aulmann ◽  
Lisa Braun ◽  
Friederike Mietzsch ◽  
Thomas Longerich ◽  
Roland Penzel ◽  
...  
Keyword(s):  
Ductal Carcinoma In Situ ◽  
Carcinoma In Situ ◽  
Ductal Carcinoma ◽  
Flat Epithelial Atypia ◽  
Low Grade ◽  
Epithelial Atypia

Flat epithelial atypia: are we being too aggressive?

2019 ◽  
Vol 179 (2) ◽  
pp. 511-517 ◽  
Author(s):  
Ashley DiPasquale ◽  
Sveta Silverman ◽  
Erene Farag ◽  
Lashan Peiris
Keyword(s):  
Flat Epithelial Atypia ◽  
Epithelial Atypia

scholarly journals Relevance of B3 lesions in breast diagnosis – frequency and therapeutic consequences

2018 ◽  
Vol 15 (03) ◽  
pp. 153-159 ◽  
Author(s):  
Christin Madjar ◽  
James Seabert ◽  
Annette Fisseler-Eckhoff ◽  
Christian Gustmann ◽  
Isabell Hoffmann ◽  
...  
Keyword(s):  
Breast Imaging ◽  
Atypical Ductal Hyperplasia ◽  
Radial Scar ◽  
Flat Epithelial Atypia ◽  
Surgical Removal ◽  
Core Needle ◽  
Ductal Hyperplasia ◽  
Vacuum Biopsy ◽  
B3 Lesions ◽  
Epithelial Atypia

AbstractWith improvements in breast imaging and minimally invasive interventions, detection of early breast cancer has increased. However, with the improved diagnostic capabilities, the risk of false-positive benign lesions as well as lesions classified as B3 by histopathology has also increased. Varying rates of malignancies are associated with B3 lesions, raising the question of whether such lesions should always be surgically removed. The results of our retrospective analysis should assist in this decision-making process.307 core needle or vacuum-assisted needle biopsies in which B3 lesions were found were examined. The most common lesions were intraductal papillomas (44 %), atypical ductal hyperplasia (22.8 %), flat epithelial atypia (9.4 %), phyllodes tumours (6.5 %), radial scars (5.9 %), LIN 1 (4.9 %), complex fibroadenomas (3.3 %) and LIN 2 (1.6 %). The frequencies depended considerably on whether the tissue was obtained by core biopsy or vacuum biopsy. Stereotactic vacuum biopsy was generally performed in the case of microcalcification not apparent on sonography. Lesions visible on ultrasound had core needle biopsy.Surgery was performed in 254 cases and a malignancy was found in 27.2 % on the final histopathology. Malignancy was found in 24.6 % of 114 cases initially diagnosed as intraductal papilloma. Similarly, cancer was discovered in 48.4 % of the 62 cases of atypical ductal hyperplasia, in 2.4 % of the 41 cases of flat epithelial atypia, complex fibroadenoma and phyllodes tumour, in 20.7 % of the 29 cases of LIN 1 and radial scar as well as in 50 % of the 8 cases of LIN 2, adenomyoepithelioma and atypical apocrine metaplasia.These data indicate the necessity for complete surgical removal of a B3 lesion when it is discovered using the core needle or vacuum-assisted biopsy technique. The decision not to perform surgery can be made when the risk of associated malignancy is deemed low in the clinical pathology conference, but careful follow-up is essential.

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