Authors: Sohn, Vance¹; Porta, Rees²; Brown, Tommy²

Source: Military Medicine, Volume 176, Number 11, November 2011 , pp. 1347-1350(4)

Publisher: AMSUS - Association of Military Surgeons of the U.S.

Abstract:

ABSTRACT

Objectives: Flat epithelial atypia (FEA) is an increasingly diagnosed breast lesion yet there remains a paucity of data regarding these findings and their clinical significance. By determining the pathologic concordance rate, we sought to evaluate the indications for surgical intervention for FEAs diagnosed on core needle biopsy (CNB). Methods: Using a retrospective review of an international pathology referral center database, we included all breast CNB specimens with FEA as the most advanced diagnosis that underwent surgical excision. Patient demographics, caliber of biopsy needle, and pathology results were then analyzed. Results: Between 2000 and 2009, 463 FEAs were diagnosed among 15,000 specimens referred for expert opinion. Twenty-four lesions (5%) met inclusion criteria. Sampling ranged from 8- to 18-guage needles. Two lesions (8.4%) were upgraded after surgical excision; one patient was found to have infiltrating ductal carcinoma and another with tubular carcinoma. Twelve patients who were diagnosed with FEA did not undergo surgical excision but had no immediate evidence of malignancy. Conclusions: Based on the 8.4% upgrade rate, FEA diagnosed on CNB requires follow-up surgical excision. Regardless of CNB caliber, the risk of sampling error precludes nonoperative management and FEA should be considered an at-risk lesion until more studies and pooled analysis prove otherwise.

Document Type: Research article

Affiliations: 1: Bassett Army Community Hospital, 1060 Gaffney Road No. 7400, Fort Wainwright, AK 99703-7400. 2: Madigan Army Medical Center, 9040 Fitzsimmons Avenue, Tacoma, WA 98431.

Publication date: 2011-11-01

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• Military Medicine is the Association's official monthly journal. The objective of the Journal is to promote awareness of Federal medicine by providing a forum for responsible discussion of common ideas and problems relevant to Federal healthcare. Its mission is: To increase healthcare education by providing scientific and other information to its readers; to facilitate communication; and to offer a prestige publication for members' writings.
  
  Military Medicine's 5-year Impact Factor: 1.061
  
  
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