BACKGROUND: Based on its cytologic features, and its co-occurrence with atypical hyperplasia and breast cancer, flat epithelial atypia (FEA) has been proposed as a precursor lesion on the pathway to the development of breast cancer. It is often referred to as an "atypical" or high-risk lesion. However, to the authors' knowledge, the long-term risk of breast cancer in women with FEA is undefined. METHODS: Specimens with FEA were identified among excisional breast biopsies in the Mayo Clinic Benign Breast Disease Cohort, which includes 11,591 women who had benign biopsy findings at the Mayo Clinic in Rochester, Minnesota between 1967 and 2001. Breast cancer risk among subsets of patients with FEA and nonproliferative, proliferative, and atypical hyperplasia (AH) was assessed using standardized incidence ratios (SIRs) compared with the Iowa Surveillance, Epidemiology, and End Results registry. RESULTS: FEA was identified in 282 women (2.4%); 130 had associated AH (46%) and 152 (54%) were classified as having proliferative disease without atypia (PDWA). With median follow-up of 16.8 years, the SIR for breast cancer in patients with AH plus FEA was 4.74 (95% confidence interval [95% CI], 3.17-6.81) versus 4.23 (95% CI, 3.44-5.13) for those with AH without FEA (P = .59). The SIR for patients with PDWA plus FEA was 2.04 (95% CI, 1.23-3.19) versus 1.90 (95% CI, 1.72-2.09) for patients with PDWA without FEA (P = .76). CONCLUSIONS: FEA is an uncommon finding in women with benign breast disease. FEA does not appear to convey an independent risk of breast cancer beyond that of the associated PDWA or AH.
BACKGROUND: Based on its cytologic features, and its co-occurrence with atypical hyperplasia and breast cancer, flat epithelial atypia (FEA) has been proposed as a precursor lesion on the pathway to the development of breast cancer. It is often referred to as an "atypical" or high-risk lesion. However, to the authors' knowledge, the long-term risk of breast cancer in women with FEA is undefined. METHODS: Specimens with FEA were identified among excisional breast biopsies in the Mayo Clinic Benign Breast Disease Cohort, which includes 11,591 women who had benign biopsy findings at the Mayo Clinic in Rochester, Minnesota between 1967 and 2001. Breast cancer risk among subsets of patients with FEA and nonproliferative, proliferative, and atypical hyperplasia (AH) was assessed using standardized incidence ratios (SIRs) compared with the Iowa Surveillance, Epidemiology, and End Results registry. RESULTS: FEA was identified in 282 women (2.4%); 130 had associated AH (46%) and 152 (54%) were classified as having proliferative disease without atypia (PDWA). With median follow-up of 16.8 years, the SIR for breast cancer in patients with AH plus FEA was 4.74 (95% confidence interval [95% CI], 3.17-6.81) versus 4.23 (95% CI, 3.44-5.13) for those with AH without FEA (P = .59). The SIR for patients with PDWA plus FEA was 2.04 (95% CI, 1.23-3.19) versus 1.90 (95% CI, 1.72-2.09) for patients with PDWA without FEA (P = .76). CONCLUSIONS: FEA is an uncommon finding in women with benign breast disease. FEA does not appear to convey an independent risk of breast cancer beyond that of the associated PDWA or AH.
Authors: Tia R Milanese; Lynn C Hartmann; Thomas A Sellers; Marlene H Frost; Robert A Vierkant; Shaun D Maloney; V Shane Pankratz; Amy C Degnim; Celine M Vachon; Carol A Reynolds; Romayne A Thompson; L Joseph Melton; Ellen L Goode; Daniel W Visscher Journal: J Natl Cancer Inst Date: 2006-11-15 Impact factor: 13.506
Authors: N Bijker; J L Peterse; L Duchateau; J P Julien; I S Fentiman; C Duval; S Di Palma; J Simony-Lafontaine; I de Mascarel; M J van de Vijver Journal: J Clin Oncol Date: 2001-04-15 Impact factor: 44.544
Authors: R Kusama; M Fujimori; I Matsuyama; L Fu; K Ishii; Y Hama; K Asanuma; K Shingu; S Kobayashi; S Tsuchiya Journal: Pathol Int Date: 2000-10 Impact factor: 2.534
Authors: Lynn C Hartmann; Thomas A Sellers; Marlene H Frost; Wilma L Lingle; Amy C Degnim; Karthik Ghosh; Robert A Vierkant; Shaun D Maloney; V Shane Pankratz; David W Hillman; Vera J Suman; Jo Johnson; Cassann Blake; Thea Tlsty; Celine M Vachon; L Joseph Melton; Daniel W Visscher Journal: N Engl J Med Date: 2005-07-21 Impact factor: 91.245
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: Sahar J Alothman; Weisheng Wang; David S Goerlitz; Md Islam; Xiaogang Zhong; Archana Kishore; Redha I Azhar; Bhaskar V Kallakury; Priscilla A Furth Journal: Cancer Prev Res (Phila) Date: 2017-03-10
Authors: Vered Stearns; Mary Jo Fackler; Seema A Khan; Saraswati Sukumar; Sidra Hafeez; Zoila Lopez Bujanda; Robert T Chatterton; Lisa K Jacobs; Nagi F Khouri; David Ivancic; Kara Kenney; Christina Shehata; Stacie C Jeter; Judith A Wolfman; Carola M Zalles; Peng Huang Journal: Cancer Prev Res (Phila) Date: 2016-06-03
Authors: John S Berry; Alfred F Trappey; Timothy J Vreeland; Adam R Pattyn; Guy T Clifton; Elizabeth A Berry; Erika J Schneble; Aaron D Kirkpatrick; Jeffrey S Saenger; George E Peoples Journal: J Cancer Date: 2016-01-01 Impact factor: 4.207
Authors: Karthik Ghosh; Robert A Vierkant; Ryan D Frank; Stacey Winham; Daniel W Visscher; Vernon S Pankratz; Christopher G Scott; Kathleen Brandt; Mark E Sherman; Derek C Radisky; Marlene H Frost; Lynn C Hartmann; Amy C Degnim; Celine M Vachon Journal: Breast Cancer Res Date: 2017-12-19 Impact factor: 6.466
Authors: Derek C Radisky; Daniel W Visscher; Ryan D Frank; Robert A Vierkant; Stacey Winham; Melody Stallings-Mann; Tanya L Hoskin; Aziza Nassar; Celine M Vachon; Lori A Denison; Lynn C Hartmann; Marlene H Frost; Amy C Degnim Journal: Breast Cancer Res Treat Date: 2016-02-04 Impact factor: 4.872