A review of columnar cell lesions of the breast in a Lagos Tertiary Health Institution: A ten-year retrospective study

Abstract

This study was to estimate the frequency of occurrence of columnar cell lesions (CCLs) in Nigerian women using Fibrocystic changes (FCC) of the breast as a surrogate lesion as well as to determine the variants of CCLs found using the standard histologic criteria.The materials for this study consisted of all consecutive breast biopsy blocks and corresponding archival slides with a previous diagnosis of FCC within a 10-year period at the department. All cases were reviewed and reclassified. The data obtained was analysed manually using simple statistical methods such as chart and tables. In this study, thirty cases of CCLs were identified among the 559 cases of FCC found. The ages of the patients ranged from 16 years to 63 years, the peak age of occurrence was in the 5th decade. The most common pattern found was Columnar Cell Change (CCC) which accounted for 66.7% of the cases. Columnar Cell Hyperplasia (CCH) accounted for 16.7%, and CCC and CCH occurred together in 16.7% of cases. No case of flat epithelial atypia (FEA) was found. The study showed that CCLs occur in Nigerian women. The FEA variant, the putative precursor of breast cancer, was not found among our cohort, most likely due to the benign surrogate lesion used for this study. FEA often co-exists with lobular neoplasia, and this entity would likely have been found if this study had included cases previously diagnosed with in situ and invasive lobular or ductal carcinoma. The age distribution of our patients was similar to that described among Caucasian women.

Key words: Columnar Cell Lesions, Fibrocystic changes, Columnar Cell Change, Columnar Cell Hyperplasia, Flat Epithelial Atypia.