Columnar cell lesions (CCL) are hypothesised as earliest pre invasive lesions of Breast cancer due to similarities with DCIS and Carcinoma. Many of the morphologic and genetic studies describe their association with low-grade carcinomas. Prevalence of CCL was studied in 37 Indian patients with Invasive Breast Carcinoma who did not receive neo-adjuvant chemotherapy with aid of 4 additional sections within 2cm of tumor edges were taken. CCL’s were identified   and classified in 26 cases (70.27%). Columnar Cell Change (CCC) were present in 13, Columnar Cell Hyperplasia (CCH) in 11, CCC with atypia in 9, CCH with atypia and CCH with atypia and complex architecture were present in 2cases each.  Distribution was extensive in 8.1%, multifocal 32.4%, and focal 29.7% cases. These findings were correlated with various known parameters assessed by chi-square and fischer’s exact test. These included patient age, menopausal status tumor size lymph node status, tumor grade, necrosis, emboli, adipose tissue infiltration, tumor lymphocytic infiltrate, margins, stage. It was concluded that CCL’s do-not correlate with any clinico-pathologic parameter and thus, are not helpful in determining prognosis of patients.

1. Foote FW, Stewart FW. Comparative studies of cancerous versus noncancerous breasts. Ann. Surg. 1945; 121: 6–53.
2. Feeley L, Quinn CM. Review Columnar Cell Lesions of Breast. Histopathology 2008; 52:11-9.
3. JG Problems in Breast Pathology. London, Philadelphia: WB Saunders; 1979.p.192-239
4. Schnitt SJ. Review: the diagnosis and management of Pre-invasive breast disease, Flat Epithelial Atypia- Classification, Pathologic features and clinical significance. Breast Cancer Res 2003; 5: 263-8
5. Leibel S, Regitnig P, Moinfar F. Flat epithelial Atypia (DIN1a, atypical columnar change): an underdiagnosed entity very frequently coexisting with lobular neoplasia. Histopathol 2007; 50: 859-65.
6. Abdel-Fatah TMA, Powe DG, Hodi Z, Lee AHS, Reis-Filho JS, EllisIO. High frequency of coexistence of columnar cell lesions, lobular neoplasia, and low grade ductal carcinoma in situ with invasive tubular carcinoma and invasive lobular carcinoma. Am. J. Surg. Pathol. 2007; 31: 417–26.
7. Seema HS, Rajalakshmi T. Columnar cell lesions of Breast- significant or not? Indian J Surg 2007; 69:191-3.
8. Goldstein N.s., O’Malley B. Cancerization of Small Ectatic Ducts of the Breast by Ductal Carcinoma in Situ Cells with Apocrine Snouts: A Lesion associated with Tubular Carcinoma. Am J of ClinPathol 1997; 5: 561-5.
9. Demiralay E, Demirham B, Kocbiyik A, Sar A, Altaca G. Immunohistochemical and morphologic findings in columnar cell lesions of breast. Indian J of Pathol and Microbiology 2011; 54:335-7.
10. Fraser JL, Raza S, Chorny K, Connolly JL, Schnitt SJ. Columnar alteration with prominent apical snouts and secretions: a spectrum of changes frequently present in breast biopsies performed for microcalcifications. Am J SurgPathol1998; 22:1521-7
11. Senetta R, Campanino PP, Mariscotti G, Garberoglio S, Daniele L, Pennecchi F et al. Columnar cell lesions associated with breast calcifications on vacuum-assisted core biopsies: clinical, radiographic, and histological correlations. Modern Pathol 2009; 22: 762–9.
12. Lavoue´ V, Roger CM, Poilblanc M, Proust N, Monghal-Verge C, Sagan C. Pure flat epithelial atypia (DIN 1a) on core needle biopsy: study of 60 biopsies with follow-up surgical excision. Breast Cancer Res Treat 2011; 125:121–6.
13. Moinfar F, Man YG, Bratthauer GL, Ratschek M, TavassoliFA.Genetic abnormalities in mammary ductal intraepithelial neoplasia-flat type (‘clinging ductal carcinoma in situ’): a simulator of normal mammary epithelium. Cancer 2000; 88: 2072–208.
14. Dabbs DJ, Carter G, Fudge M, Peng Y, Swalsky P, Finkelstein S. Molecular alterations in columnar cell lesions of the breast. Mod Pathol 2006; 19:344-9.
15. Aulmann S, Elsawaf Z, Penzel R, Schirmacher P , Sinn HP. Invasive Tubular Carcinoma of the breast frequently is clonally related to Flat epithelial Atypia and low grade Ductal carcinoma in situ. Am J SurgPathol 2009; 33: 1646-53.
16. Boulos FI, Dupont WD, Simpson JF, Schuyler PA, Sanders ME, Freudenthal ME, Page DL. Histologic associations and long-term cancer risk in columnar cell lesions of the breast: a retrospective cohort and a nested case-control study. Cancer 2008; 113:2415-21
17. Aroner SA, Collins LC, Schnitt SJ, Connolly JL, Colditz GA, Tamimi RM. Columnar cell lesions and subsequent breast cancer risk: a nested case-control study. Breast Cancer Research 2010; 12:R61.

Roopal Rathi

Address: 186, Manavta Nagar, Kanadia Road, Indore- 452016

Phone numbers: 08447631119, Email: This email address is being protected from spambots. You need JavaScript enabled to view it.