Histopathological Study of the Relationship of Columnar Cell Lesions to Carcinoma Breast

ABSTRACT

Introduction: Columnar cell lesions (CCLs) of the breastcomprise a spectrum of benign to atypical entities that have incommon variably dilated terminal duct lobular units lined bycolumnar epithelial cells with prominent apical cytoplasmicsnouts. They are increasingly being encountered in breastbiopsies because their associated microcalcifications aredetected on mammographic screening. Current study aimed toknow the proportion and significance of columnar cell lesionsseen along with carcinoma breast.Material and methods: Excision biopsy specimens of thebreast which included both lumpectomies and mastectomieswere studied in the department of pathology. Postchemotherapy specimens were excluded from the study.5sections each were taken from adjacent breast tissuesand studied for columnar cell lesions after staining withhematoxylin, and eosin.100 cases were included in this study.Results: Majority of the cases were diagnosed as IDC grade 2.One or the other columnar cell lesions were seen in the majorityof invasive ductal carcinomas. CCLs may be characterized bya single layer of columnar cells (columnar cell change [CCC]),multiple layers with stratification and apical tufting (columnarcell hyperplasia [CCH]), or monomorphic cells with cytologicatypia (flat epithelial atypia [FEA]). The differentiationbetween CCC, CCH, and FEA is clinically significant CCCand CCH are considered benign lesions, whereas FEA canbe associated with, and even a precursor to, low-grade ductalcarcinoma in situ and atypical ductal hyperplasia. Of the total12 cases of grade 2 IDC, 8 cases (66.6%) showed columnarcell change, 4 of them showed columnar cell hyperplasia(33.3%) and 9 of them showed both flat epithelial atypia andductal carcinoma in-situ changes (75%).Conclusion: A consistent correlation exists between columnarcell lesions and Carcinoma Breast which is evidenced by thepresence of such lesions in diagnosed cases of carcinoma.Since columnar cell lesions represent a significant precursorfor carcinoma breast, a multidisciplinary modality of approachwill help to detect these lesions much earlier and will proveworthwhil