Flat Epithelial Atypia (FEA) of the Breast
The Flat Epithelial Atypia (FEA) is a benign breast lesion that is often detected through biopsy after a finding microcalcifications in mammography. This lesion is located at the point where the lobia (the structures that produce milk) meet the milk ducts (which carry it to the nipple) and is characterized by the presence of slightly atypical (abnormal) cells.
How Serious Is FEA?
FEA is considered a defect low to intermediate risk for development breast cancer, especially when it coexists with other alterations such as Atypical Hyperplasia or ductal carcinoma in situ (DCIS). Recent studies emphasize that FEA alone rarely progresses to invasive cancer, but its presence suggests a wider unstable area in the mass parenchyma. However, because in a small percentage (approximately 5%) the presence of more serious damage may be underestimated, careful evaluation is required.
In addition, the Flat Epithelial Atypia (FEA) may coexist with other high-risk lesions, such as Atypical Ductal Hyperplasia or Ductal Carcinoma In Situ (DCIS).
What Is the Proper Management?
The approach has now been more personalized and according to recent guidelines and studies, the decision to surgical resection or simple tracking based on:
- In agreement with the pathological findings mammographic characteristics
- Στην sample adequacy (if the biopsy completely covers the suspicious area)
- Στην Presence or absence of other associated lesions
In cases of isolated FEA and full correlation with imaging, the active monitoring is considered an acceptable alternative to resection.
If her diagnosis FEA placed after a needle biopsy, it may be recommended supplementary surgical resection in the following cases:
- When the pathological result does not agree with the mammographic findings.
- There is doubt about the adequacy of the biopsy sample
On the contrary, if the lesion is diagnosed with surgical biopsy, and it is confirmed that the removal was adequate, then no further treatment is required beyond the regular mammological check-up.
Even when surgical treatment is not required, it is important to systematic monitoring by a specialized mammologist, as FEA may indicate a high biological risk environment.
What You Should Know
The correct diagnosis and management of Squamous Epithelial Atypia is essential for protecting breast health and preventing possible future risks. Regular check-ups and working with a specialized mammologist help ensure the best possible care.
At breastaware.gr , you will find reliable, scientifically backed information about all breast conditions. Our goal is to provide you with the knowledge and support you need to care for your health with confidence and peace of mind.
Bibliography:
- Xie CL, Whitman GJ, Middleton LP, Bevers TB, Bedrosian I, Chung HL. Isolated Flat Epithelial Atypia: Upgrade Outcomes after Multidisciplinary Review-Based Management Using Excision or Imaging Surveillance. Journal of Breast Imaging. 2023 Sep 1;5(5):575–584.
- Vegunta S, Mussallem DM, Kaur AS, Pruthi S, Klassen CL. Atypical hyperplasia of the breast: Clinical cases and management strategies. Cleveland Clinic Journal of Medicine. 2023 Jul;90(7):423–431.
- Jaffar N, Khan A, Batool R, Rahat N. Spectrum of Flat Epithelial Atypia in Various Breast Lesions: An Alarming Sign. Life and Science. 2023;4(4):415–420.
- Adams AL. Flat epithelial atypia: a review of current concepts. The Breast. 2024;70:123–130.
- Said SM, Visscher DW, Nassar A, et al. Flat epithelial atypia and risk of breast cancer: A Mayo cohort study. Cancer. 2015 May 15;121(10):1548–1555.
