Columnar Cell Lesions in Fibrocystic Change of the Breast: The Incidence and Relationship with Microcalcifications

ABSTRACT

BACKGROUND: Columnar cell lesions (CCLs) are characterized by the presence of columnar epithelial cells lining the terminal duct lobular units of the breast and frequently found in biopsies for microcalcifications. Their incidence and relationship with other lesions and the locations of microcalcifications have not been established. METHODS: We reviewed 1,038 cases of fibrocystic change (FCC) for the degrees of CCLs and ductal proliferative change (PC) and the locations of microcalcifications. RESULTS: Among 1,038 FCC cases, CCLs were found in 18.9%, columnar cell change (CCC) in 12.5%, columnar cell hyperplasia (CCH) in 5.3% and flat epithelial atypia (FEA) in 1.1%. CCLs were found in 14.2%, 28.8%, and 40.0% of non-PC (NPC), proliferative disease (PD) without atypia and PD with atypia, respectively. Microcalcifications were found in 33.5%, 56.2%, 61.8%, and 81.8% of caese without CCLs, with CCC, CCH and FEA, respectively. Their locations were in NPC in 66.3% of the cases, PD in 14.8% of the cases or both areas in 18.8% of FCC. CONCLUSIONS: The incidence of CCLs increased according to the degree of PD without positive correlation between the degree of CCLs and PD. The frequency of microcalcifications increased according to the degree of CCLs but was statistically insignificant. There is a possibility that a needle biopsy targeting a microcalcification area might leave additional PD around the targeted area because microcalcifications were found more frequently in NPC than PD area.