Surveillance is safe for noncancerous, high-risk breast lesions

Editor's Note

High-risk, noncancerous flat epithelial atypia (FEA) breast lesions can be treated with close observation rather than surgical removal in most cases, this study finds.

The analysis of 208 patients diagnosed with FEA over a 9-year period found that after mammography, biopsy, and surgical excision, five lesions (2.4%) were upgraded to breast cancer, and 29.8% were upgraded to a higher-risk but noncancerous lesions.

The five cancerous lesions were ductal carcinoma in situ, and none were invasive breast cancer. FEA lesions in patients with a genetic mutation were more likely to upgrade to malignancy than those in patients without a mutation (33.3% [1 of 3] vs 2%).

The researchers concluded that surveillance of FEA is a reasonable option for patients without a genetic mutation who are not interested in chemoprevention.

Our aim was to determine upgrade rates of pure flat epithelial atypia (FEA) to malignancy
and higher-risk lesions and to identify patients with FEA at low risk for upgrade.

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