Clinicopathologic characteristics of carcinomas that develop after a biopsy containing columnar cell lesions
Evidence against a precursor role
Article first published online: 14 SEP 2011
Copyright © 2011 American Cancer Society
Volume 118, Issue 9, pages 2372–2377, 1 May 2012
How to Cite
Boulos, F. I., Dupont, W. D., Schuyler, P. A., Sanders, M. E., Page, D. L., Fedda, F. A. and Simpson, J. F. (2012), Clinicopathologic characteristics of carcinomas that develop after a biopsy containing columnar cell lesions. Cancer, 118: 2372–2377. doi: 10.1002/cncr.26523
- Issue published online: 20 APR 2012
- Article first published online: 14 SEP 2011
- Manuscript Accepted: 5 AUG 2011
- Manuscript Revised: 21 JUL 2011
- Manuscript Received: 4 JUN 2011
- breast cancer;
- columnar cell lesion;
- columnar cell atypia;
- cancer progression;
- precursor lesions
Columnar cell lesions are frequently associated with atypical ductal hyperplasia, lobular neoplasia, and tubular carcinoma, and have been suggested as a precursor lesion for low-grade carcinomas. However, in long-term follow-up studies, columnar cell lesions are associated with only a slight increase in later breast cancer development. If columnar cell lesions are precursor lesions, one would expect subsequent cancers to develop at the same site as the biopsy and to be preferentially of low grade. The goal of this article is to review the clinical and pathologic features of carcinomas that develop after a diagnosis of columnar cell lesion to try to establish whether these lesions are precursors to low-grade invasive carcinoma.
The authors reviewed biopsies containing columnar cell lesions, using the criteria of Schnitt and Vincent-Salomon, from 77 women in the Nashville Breast Cohort who developed subsequent breast carcinoma. Clinicopathologic features including laterality, type, and grade of the subsequent cancer were recorded.
Breast cancer developed a median of 11 years after initial biopsy. The median age at diagnosis was 60 years. The majority of invasive carcinomas were of no special type and of intermediate grade. Moreover, the carcinomas were as likely to occur in the contralateral breast as in the breast that was originally diagnosed with columnar cell lesion, regardless of columnar cell lesion subtype (P = .48).
Carcinoma subsequent to columnar cell lesions may occur in either breast and tends to show a similar grade and type distribution as sporadic breast cancer. These findings argue against columnar cell lesions being a true precursor for low-grade invasive carcinoma. Cancer 2012. © 2011 American Cancer Society.