Columnar cell lesions of the breast — significant or not?

Abstract

Columnar cell lesions (CCL) of the breast range from the innocuous CAPSS (Columnar alteration with prominent apical snouts and secretions) to DCIS. Their precancerous potential poses diagnostic and therapeutic riddles, especially for those with mammographic microcalcifi cations.Aim To document the incidence of columnar cell lesions in the breast, to study their morphologic spectrum and to study the signifi cance of their association with benign and malignant breast lesions. Material and methodsWe studies 100 consecutive breast specimens. These specimens included biopsies, lumpectomies and mastectomies. Columnar cell lesions were classifi ed as per Schnitt criteria. Associated lesions in the adjacent tissue were also studied.Results Of the 100 samples (43 malignant and 57 benign), 37 cases showed CCL: CAPSS 23, columnar cell hyperplasia-11 and Columnar cell hyperplasia with atypia-3. The commonest associated lesion was fi brocystic change (n=54). Their incidence in benign and malignant lesions was 42% and 30% respectively, with no statistical significance in the difference. Lesions with atypia were seen only in malignant cases. ConclusionColumnar cell lesions are common, and often overlooked. These lesions are seen in association with both benign and malignant breast lesions. It is only the presence of atypia in CCL that warrants a special mention and necessitates follow up, and resection if indicated.

A study of incidence of columnar cell lesions in neoplastic and non –neoplastic lesions of breast

“…The remaining 11% of cases showed Columnar cell hyperplasia without atypia. Similar findings were seen in the study done by Seema et al [9]where the commonest associated lesion was Fibrocystic change which is seen in 54% of cases. In a study done byIm Choi Soo et al [10] with CCH without atypia.…”

“…Columnar cell lesions have recently become a highly controversial area in breast pathology.Over the past few years there has been an abundance of evidence linking them to atypical hyperplasia and invasive carcinomas.We conducted this observational study to gain more insight into the co-occurrence of CCL with other breast lesions. We found an incidence of CCL to be 67% in the current study, compared to study done by Seema etal [9] which showed an incidence of 37%.…”

Columnar Cell Lesions in patients with Invasive Breast Carcinoma and their correlation with clinico-pathological characteristics.

“…In 1970 Azzopardi was the first to describe them in relation to cancer giving the term 'Clinging Carcinoma'. 3 Most accepted terminology by all is classification by Schnitt [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17] This has led to the hypothesis that CCL may be the earliest morphological pre-invasive lesions of low-grade Breast cancer. The few longitudinal studies [23][24][25][26] conducted however, are inconclusive.…”