TY - JOUR
T1 - Clinical, imaging, and intervention factors associated with the upgrade of isolated flat epithelial atypia
AU - Alencherry, Erin
AU - Goel, Rakhee
AU - Gore, Sarah
AU - Thompson, Cheryl
AU - Dubchuk, Christina
AU - Bomeisl, Philip
AU - Gilmore, Hannah
AU - Dyhdalo, Kathryn
AU - Plecha, Donna M.
N1 - Publisher Copyright:
© 2018 Elsevier Inc.
PY - 2019/3/1
Y1 - 2019/3/1
N2 - Purpose: This study aims to determine clinical, imaging, and intervention factors associated with the upgrade of flat epithelial atypia (FEA) diagnosed on vacuum-assisted biopsy (VAB) in order to formulate criteria for excision and better assist in management. Methods: Between 2012 and 2015, 254 patients had a form of atypia diagnosed on ultrasound, MRI or stereotactic VAB and met eligibility for this study. Demographic, imaging, biopsy and pathology characteristics were analyzed for association with upgrade. We compared isolated FEA to all of the atypias grouped together. Results: Of the 254 atypia lesions, 72 (28%) were isolated FEA, and the upgrade rate was 2.8% (2/72). Statistically significant factors present with upgrade of isolated FEA include personal history of breast cancer and cancer diagnosis on a concurrent separate core biopsy. Other factors associated with upgrade include first degree family history of breast cancer, segmental calcification distribution, extent of calcifications >2 cm, and <25% of calcifications removed on biopsy. Conclusion: In patients with biopsy results of isolated FEA, in the absence of personal or first degree family history of breast cancer, cancer on a concurrent biopsy, segmental calcification distribution, extent of calcifications >2 cm, and only 0–24% calcifications removed on biopsy, patients may be safely followed with imaging, avoiding unnecessary excision.
AB - Purpose: This study aims to determine clinical, imaging, and intervention factors associated with the upgrade of flat epithelial atypia (FEA) diagnosed on vacuum-assisted biopsy (VAB) in order to formulate criteria for excision and better assist in management. Methods: Between 2012 and 2015, 254 patients had a form of atypia diagnosed on ultrasound, MRI or stereotactic VAB and met eligibility for this study. Demographic, imaging, biopsy and pathology characteristics were analyzed for association with upgrade. We compared isolated FEA to all of the atypias grouped together. Results: Of the 254 atypia lesions, 72 (28%) were isolated FEA, and the upgrade rate was 2.8% (2/72). Statistically significant factors present with upgrade of isolated FEA include personal history of breast cancer and cancer diagnosis on a concurrent separate core biopsy. Other factors associated with upgrade include first degree family history of breast cancer, segmental calcification distribution, extent of calcifications >2 cm, and <25% of calcifications removed on biopsy. Conclusion: In patients with biopsy results of isolated FEA, in the absence of personal or first degree family history of breast cancer, cancer on a concurrent biopsy, segmental calcification distribution, extent of calcifications >2 cm, and only 0–24% calcifications removed on biopsy, patients may be safely followed with imaging, avoiding unnecessary excision.
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U2 - 10.1016/j.clinimag.2018.11.008
DO - 10.1016/j.clinimag.2018.11.008
M3 - Article
C2 - 30500455
AN - SCOPUS:85057287442
SN - 0899-7071
VL - 54
SP - 21
EP - 24
JO - Clinical Imaging
JF - Clinical Imaging
ER -
