Columnar Cell Lesions of the Breast: Mammographic Findings with Histopathologic Correlation

Pandey, Shilpa; Kornstein, Michael J.; Shank, Whitney; Paredes, Ellen Shaw de

doi:10.1148/rg.27si075515

Cited by 36 publications

(17 citation statements)

References 30 publications

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“…When found at margins of resection specimens, no further surgery is necessary as long as calcifications have been completely removed (LoE 3b C, AGO ++). Recommended intervals (24 months) of the mammography screening program need not be shortened [23][24][25][26][27]. LIN (atypical lobular hyperplasia, lobular carcinoma in situ, LCIS/CLIS) provides an incidental finding and is not suited to explain any radiographic abnormality.…”

Section: Lifestyle Factorsmentioning

confidence: 99%

Update 2010 of the German AGO Recommendations for the Diagnosis and Treatment of Early and Metastatic Breast Cancer – Chapter B: Prevention, Early Detection, Lifestyle, Premalignant Lesions, DCIS, Recurrent and Metastatic Breast Cancer

Thomssen

Harbeck

2010

Breast Care

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Section: Lifestyle Factorsmentioning

confidence: 99%

Update 2010 of the German AGO Recommendations for the Diagnosis and Treatment of Early and Metastatic Breast Cancer – Chapter B: Prevention, Early Detection, Lifestyle, Premalignant Lesions, DCIS, Recurrent and Metastatic Breast Cancer

Thomssen

Harbeck

2010

Breast Care

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“…Columnar cell lesions (CLL) and FEA are usually detected as fine amorphous microcalcifications (often with ductal arrangement or some pleomorphism) [60]. In some cases, CLL may present as a (small) uncharacteristic mass on mammography or US.…”

Section: Columnar Cell Lesions and Feamentioning

confidence: 99%

B3 Lesions: Radiological Assessment and Multi-Disciplinary Aspects

Heywang‐Köbrunner¹,

Nährig²,

Hacker³

et al. 2010

Breast Care

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B3 lesions comprise different histopathological entities that are considered benign but ‘of unknown biological potential’. These entities may act as risk indicators (for both breasts) or as non-obligatory precursors of malignancy. Being diagnosed at percutaneous breast biopsy, an additional risk of underestimate exists. Imaging appearances, histopathological appearance and risk of associated malignancy are presented. B3 lesions of high risk, which thus should usually be excised, include atypical ductal hyperplasia (ADH), pleomorphic or necrotic type of lobular neoplasia (LIN 3), and papillary lesions with atypias. Intermediate risk may be associated with classic lobular carcinoma in situ (LIN 2) or flat epithelial atypia (FEA), and low risk with radial sclerosing lesions (RSLs) and papillary lesions without atypias. LIN 1 is mostly an incidental finding acting as risk indicator. Follow-up is adequate if the initial diagnostic problem is solved. According to international guidelines, risk and subsequent recommendations should be discussed for each individual patient, taking into account biological risk, representative sampling, lesion size, lesion extent, percentage of lesion removal, other individual risks, and the possibility of surveillance. With vacuumassisted breast biopsy (VABB), surgery may be avoided for more of the small lesions at low risk. Further data collection and diligent evaluation may help to better assess the individual risk, to better adapt treatment recommendations and avoid overtreatment.

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“…CCLs have been described by a variety of terms, including columnar cell change or columnar cell hyperplasia with or without atypia, columnar metaplasia, columnar alteration of lobules, blunt duct adenosis, columnar alteration with prominent snouts and secretions, enlarged lobular units with columnar alterations, hyperplastic unfolded lobules and hyperplastic enlarged lobular units [2,3]. The World Health Organization Working Group on the Pathology and Genetics of Tumors of the Breast recommended the term flat epithelial atypia (FEA) for CCLs containing atypia.…”

Section: Introductionmentioning

confidence: 99%

“…Recently, advanced digital mammography (MG) techniques have allowed for better detection of microcalcifications. Accordingly, the number of biopsies has increased, which has led to the increased detection of CCLs [3]. If specific radiological characteristics of CCLs with atypia can be detected, there may be little need for biopsy in the future.…”

Section: Introductionmentioning

confidence: 99%

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Columnar cell lesions of the breast: radiological features and histological correlation

Aktaş¹,

Burcu²,

Çiledağ³

et al. 2015

Med Ultrason

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Objective: This study aimed at investigating the characteristic imaging findings of the columnar cell lesions (CCLs) of the breast via mammography (MG), ultrasonography (US), and magnetic resonance imaging (MRI). Materials and methods: The MG, US and MRI findings of 72 patients with histopathological diagnosis of CCLs were retrospectively evaluated. Histopathologically, the CCLs were divided into those with and without atypia; the radiological findings of these two groups were compared with a Chi-square test. Results: Sixty-nine patients underwent stereotaxic biopsy (MG-guided in 50 patients and US-guided in 19 patients) and 3 patients underwent US-guided core needle biopsy; all of these patients were diagnosed with CCLs based on a histological examination. The evaluation of the CCLs in patients that underwent MG-guided stereotaxic biopsy revealed that the most common type of microcalcifications were amorphous-indistinct (52%, n= 26/50) and the most common microcalcification distribution pattern was clustered type (76%, n= 38/50). The ratio of CCLs with atypia was similar in patients with high-risk microcalcifications and in those with benign or intermediate-risk microcalcifications (OR: 1.13, 95% CI: 0.573-2.227, p: 0.475). On the other hand, those patients who underwent US-guided biopsies for the evaluation of CCLs had similar proportions of cystic or solid lesions, posterior acoustic shadowing and contour irregularities whether or not they had atypia (p: 0.584, 0.075, 0.187, respectively). Patients with atypia had a higher number of lesions greater than 1 cm via US as compared to those without atypia, but this difference was not statistically significant (p: 0.06). MRI findings were also similar in patients with and without atypia. Conclusions: MG revealed that clustered distribution patterns and amorphous-indistinct type microcalcifications were more commonly seen in patients with CCLs; however, there was no significant relationship between US or MRI findings and CCLs. In addition, the MG, US and MRI findings were similar in patients with CCLs that did or did not have histopathological characteristics of atypia.

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Columnar Cell Lesions of the Breast: Mammographic Findings with Histopathologic Correlation

Cited by 36 publications

References 30 publications

Update 2010 of the German AGO Recommendations for the Diagnosis and Treatment of Early and Metastatic Breast Cancer – Chapter B: Prevention, Early Detection, Lifestyle, Premalignant Lesions, DCIS, Recurrent and Metastatic Breast Cancer

Update 2010 of the German AGO Recommendations for the Diagnosis and Treatment of Early and Metastatic Breast Cancer – Chapter B: Prevention, Early Detection, Lifestyle, Premalignant Lesions, DCIS, Recurrent and Metastatic Breast Cancer

B3 Lesions: Radiological Assessment and Multi-Disciplinary Aspects

Columnar cell lesions of the breast: radiological features and histological correlation

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