Breast core biopsy with 8 cores. There are multiple breast lesions. Try you diagnosis one by one.

Lesion 1 20x and 400x

 good case!

good discuss!

 Seem most of you agree the interpretation of F 1-4, 6. You can give your reasons if you do not agree.

F 5, 7involve columinar  cell change, 平坦型上皮非典型性（FEA) and related lesions. FEA is a very controversial term. There are many issues which are not clear, such as dx criteria, managment: present in in core biopsy, in excisional bx, .in surgical margins. In fact even in the US, many general surgical pathologists do not know the term or do not know how to make the diagnois. Of cause most of surgens know nothing about FEA.  We have alot of consult cases from other hospitals. Often we need to talk with primary pathologists. This is why I know a lot of general pathologists do not know the term well.

Interesting to know that our pathologists in China use this term or not. Please share your knowledge about FEA with ours.

Thanks

 Yes, We use the terminology of columnar cell lesion in  diagnosis.

The columnar  cell lesion especially flat cell atypia is related to some low grade carcinoma such as tubular carcinoma, tubulobular carcinoma etc. However, I am puzzled about FEA accompany with structure complex, should  it be diagnosed as atypic duct hyperplasia or FEA, just as  figures shown in lesion 7? According to the definition of FEA there should not have structure complex.

Interested in the topic very much.

Thanks!