OBJECTIVE: This systematic review was conducted to provide treatment recommendations for patients with a diagnosis of columnar cell lesions (CCLs) in a breast core needle biopsy (CNB). BACKGROUND: CCLs are putative breast cancer precursors and are often associated with (in situ) carcinoma in excision specimens. Although several studies reported on the progression risk and underestimation rate of a CNB diagnosis of CCL, there is no consensus regarding optimal clinical management in this context. METHODS: We searched MEDLINE, Embase, and Cochrane databases from 1990 to October 2010 for studies on patients with a CNB diagnosis of CCL without atypia, CCL with atypia and atypical ductal hyperplasia associated with CCL followed by surgical excision or clinical follow up. RESULTS: Of 1759 selected articles, 24 were included in this review. The pooled underestimation risks for (in situ) carcinoma were as follow: CCL without atypia 1.5% (95% confidence interval [CI] 0.6%-4%), CCL with atypia 9% (95% CI: 5%-14%), and atypical ductal hyperplasia associated with CCL 20% (95% CI: 13%-28%), based on the whole groups of patients with a CNB. Studies including CCLs with long-term clinical follow-up showed a trend toward a limited elevated breast cancer risk. CONCLUSIONS: On the basis of the (in situ) carcinoma underestimation rates of patients with a CNB diagnosis of CCL with atypia and atypical ductal hyperplasia associated with CCL, surgical excision should be considered. For CCL without atypia, more studies with a long-term follow-up are required, but so far, surgical excision biopsy does not seem to be necessary.
OBJECTIVE: This systematic review was conducted to provide treatment recommendations for patients with a diagnosis of columnar cell lesions (CCLs) in a breast core needle biopsy (CNB). BACKGROUND: CCLs are putative breast cancer precursors and are often associated with (in situ) carcinoma in excision specimens. Although several studies reported on the progression risk and underestimation rate of a CNB diagnosis of CCL, there is no consensus regarding optimal clinical management in this context. METHODS: We searched MEDLINE, Embase, and Cochrane databases from 1990 to October 2010 for studies on patients with a CNB diagnosis of CCL without atypia, CCL with atypia and atypical ductal hyperplasia associated with CCL followed by surgical excision or clinical follow up. RESULTS: Of 1759 selected articles, 24 were included in this review. The pooled underestimation risks for (in situ) carcinoma were as follow: CCL without atypia 1.5% (95% confidence interval [CI] 0.6%-4%), CCL with atypia 9% (95% CI: 5%-14%), and atypical ductal hyperplasia associated with CCL 20% (95% CI: 13%-28%), based on the whole groups of patients with a CNB. Studies including CCLs with long-term clinical follow-up showed a trend toward a limited elevated breast cancer risk. CONCLUSIONS: On the basis of the (in situ) carcinoma underestimation rates of patients with a CNB diagnosis of CCL with atypia and atypical ductal hyperplasia associated with CCL, surgical excision should be considered. For CCL without atypia, more studies with a long-term follow-up are required, but so far, surgical excision biopsy does not seem to be necessary.
Authors: Laura S Samples; Mara H Rendi; Paul D Frederick; Kimberly H Allison; Heidi D Nelson; Thomas R Morgan; Donald L Weaver; Joann G Elmore Journal: Breast Date: 2017-05-03 Impact factor: 4.380
Authors: Benjamin C Calhoun; Amy Sobel; Richard L White; Matt Gromet; Teresa Flippo; Terry Sarantou; Chad A Livasy Journal: Mod Pathol Date: 2014-11-21 Impact factor: 7.842
Authors: Marco Lucioni; Chiara Rossi; Pascal Lomoro; Francesco Ballati; Marianna Fanizza; Alberta Ferrari; Carlos A Garcia-Etienne; Emanuela Boveri; Giulia Meloni; Maria Grazia Sommaruga; Elisa Ferraris; Angioletta Lasagna; Elisabetta Bonzano; Marco Paulli; Adele Sgarella; Giuseppe Di Giulio Journal: Eur Radiol Date: 2020-08-20 Impact factor: 5.315
Authors: Anoek H J Verschuur-Maes; Cathy B Moelans; Peter C de Bruin; Paul J van Diest Journal: Cell Oncol (Dordr) Date: 2014-04-02 Impact factor: 6.730