Columnar cell lesions and Flat epithelial atypia in mastectomy specimens – An institution based study in North Kerala

Introduction: Columnar cell lesions (CCL) are thought to be low grade precursor lesions of breast cancer. The prevalence of these lesions has not been well documented in the published literature. Data regarding the same in Indian scenario is also scarce. The present study attempts to document the extent and pattern of distribution of CCL and other proliferative breast lesions in the mastectomy specimens received in our department. Objectives: To find the prevalence of CCL in the mastectomy specimens and to find out the prevalence of various known risk factors in the study population. Materials and Method: The patients who underwent mastectomy or breast conservation surgery for carcinoma breast during December 2012 to May 2014 were included in the descriptive study conducted in the Department of Pathology, Government Medical College, Kozhikode. After taking informed consent clinical details were collected from the patient. Mastectomy specimens were evaluated for the presence of proliferative breast lesions. The variables were statistically analyzed using SPSS version 16.0. Results 60 patients were included in the study. Most of the patients belonged to the age group of 51-60 years. 16 cases were premenopausal and rest 44 postmenopausal. Histological grade 2 was most common and majority of our cases presented in TNM stage 2a. 56.7% cases showed proliferative breast lesions. DCIS was the commonest, seen in 40% cases. CCL were seen in 33.3% cases. No statistically significant relation was obtained between proliferative breast lesions and tumor grade, stage, nodal status, fibrocystic change, triple negativity of the tumor and menopausal status of the patient. As tumor grade progressed, triple negative tumors also increased and this was statistically significant (p<0.05). Conclusion: In our study columnar cell and other proliferative breast lesions were seen in 56.7% mastectomies but CCL did not show any significant relation to menopausal status of the patient, tumor grade, tumor stage, nodal status, fibrocystic breast disease and triple negativity of the tumor.