Columnar Cell Hyperplasia

taraleec

Does anyone know or have you heard anything about Columnar Cell Hyperplasia with Atypia?  I've tried searches and from what I'm finding, it's a pre-cancer.  Possibly pre-cursor to DCIS or IDC.  Thank you. 

Tinkerbell99

yes that is exactly what that is..i have it to & did a google search...

kreativek

I'm not sure about the "columnar cell" part, but this sounds like a type of atypical hyperplasia.

There is atypical lobular hyperplasia (ALH) and atypical ductual hyperplasia (ADH).  It is the "atypical" part that makes this bad- hyperplasia by itself isn't bad I'm told.  The cells are not normal, but not cancer yet either - they are "atypical".  I had ADH and it was considered the stage before DCIS; it is a "pre-cancer".  The cells are removed and the area checked for any malignant cells during an "excisional biopsy" (basically a lumpectomy) usually.

Atypical hyperplasia raises your risk of a future breast cancer at least 4-5 times.  If you have a family history it raises your risk even more.  After removing the cells, close follow up (every 6 months) as well as Tamoxifen are usually recommended.  My personal preference was to have a preventive mastectomy and implant reconstruction.  I've had so much breast cancer in my family and I didn't want to do tamoxifen.  Again,this was just my preference as I didn't want to deal with being so high risk (due to family history and ADH and dense breasts).

Anonymous

tara----having LCIS, you are already a step beyond ALH/ADH on the bc spectrum. LCIS confers  twice as much risk as atypia does. I took tamox for 5 years and am continuing with high risk surveillance of alternating mammos and MRIs; now I take evista  for further prevention.

Anne

taraleec

awb:  This is the 5th lumpectomy results, being the 3rd out of the right side.  After being dx with LCIS, ALH, ADH, columnar cell change, radial scar, sclerosing adenosis etc. in the left. 

leaf

This is from the Stanford site. http://surgpathcriteria.stanford.edu/breast/flat_epithelial_atypia/

including alternate names.  They say it does NOT reach the criteria for ADH.

These results seem to indicate that the risk of FEA progressing to invasive cancer is extremely low. However, Schnitt and Collins (3) suggest that the presence of FEA in an excisional biopsy specimen should prompt releveling of the block and a careful search for areas of ADH and DCIS....The diagnostic reproducibility of FEA compared with that of nonatypical CCLs is a concern. In one study in which the pathologists used their own criteria to classify CCLs, there was only 40% agreement as to the presence of cytologic atypia (39). However, in another study in which experienced breast pathologists were given specific training in classifying CCLs, a much higher level of agreement was observed (91.8%) (40).... Studies correlating the outcome of patients in whom excisional biopsy reveals FEA have shown a rate for local recurrence of FEA of 2.6% and an identical rate for invasive breast cancer in the ipsilateral breast (22). As mentioned earlier, the risk of FEA progressing to invasive cancer appears to be very low, despite the histologic and genetic similarities between FEA and DCIS (3) http://radiographics.rsna.org/content/27/suppl_1/S79.full

LISAMG

From the research I have read, atypical hyperplasia with columnar cell changes does put one at a higher risk for BC, but how much remains controversial. The following articles may be of some help.

Columnar cell lesions of the breast: an update and significance on core biopsy.

http://www.ncbi.nlm.nih.gov/pubmed/19089736?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed

 Update on percutaneous needle biopsy of nonmalignant breast lesions.

http://www.ncbi.nlm.nih.gov/pubmed/19546607?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed

taraleec

Doctors are telling me that COLUMNAR CELL HYPERPLASIA WITH ATYPIA is a step further than ADH, and a step before either DCIS or IDC.