FEA in breast pathology refers to Flat Epithelial Atypia, an alteration of terminal duct-lobular units in the breast characterized by a proliferation of ductal epithelium with low-grade atypia.
Understanding Flat Epithelial Atypia (FEA)
FEA is considered a benign lesion with an increased risk of developing breast cancer. Because of this risk, understanding its characteristics and management is important.
Key Characteristics of FEA:
- Location: Arises in the terminal duct-lobular units (TDLUs) of the breast.
- Cellular Appearance: Involves a proliferation of ductal epithelial cells showing low-grade atypia. This means the cells have slightly abnormal features under a microscope.
- Diagnosis: Typically identified through core needle biopsy (CNB) or surgical excision.
- Management: There is no standard management, some doctors will monitor FEA closely with regular screening while others may recommend surgical excision to eliminate the FEA and rule out more concerning pathology.
Clinical Significance
FEA is generally considered a marker for increased breast cancer risk. Its presence can influence decisions about breast cancer screening and preventative strategies. While FEA is a benign condition, its association with a higher risk necessitates careful evaluation and management.
Management Considerations
The reference specifies that currently "no consensus exists on whether the diagnosis of FEA in core needle biopsy (CNB) requires excision (EXC)." Thus, the decision to excise FEA found on a CNB depends on various factors, including:
- Patient history: Personal and family history of breast cancer.
- Imaging findings: Concordance with imaging.
- Pathology results: The presence of other atypical lesions.
- Patient preference: After discussing risks and benefits.
