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Practical point

Practical point. There are some situations where atypia is noted, but other factors preclude a diagnosis of FEA, ADH, or DCIS. E.g. Very few cells, fragmented specimen, only in lobules. May use something along the lines of: Epithelial proliferation with atypia, see comment.

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Practical point

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  1. Practical point • There are some situations where atypia is noted, but other factors preclude a diagnosis of FEA, ADH, or DCIS. • E.g. Very few cells, fragmented specimen, only in lobules. • May use something along the lines of: • Epithelial proliferation with atypia, see comment. • Results in close follow-up, re-core, excision, depending on clinical/radiographic setting.

  2. CCC FEA

  3. Risks and management * 3 or more foci on core biopsy and micropapillary architecture predict greater risk. ** Limited data and wide variation in reported upgrade rate.

  4. Diagnostic reproducibility • Multiple studies have indicated that interobserver agreement is poor, particularly when standardized criteria are not used. • Most variability among ADH vs small volume LG DCIS • In one study, diagnostic consistency was not significantly better when interpretation was confined to a single image, rather than the whole slide(s), reflecting inconsistencies in morphological interpretation • ?Concerns re accurate risk of breast ca development because of this Elston et al. Eur J Cancer 2000; 36: 1769-72.

  5. Diagnostic reproducibility Jain et al. Mod Pathol 2011 Jul;24(7):917-23.

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