Columnar cell change on core biopsy: radiological features and outcome

Introduction

Columnar cell change (CCC) is diagnosed on core biopsies performed for indeterminate microcalcification. The diagnosis of columnar cell change on stereotactic core biopsy presents a management difficulty because of uncertainty regarding the pathological and clinical significance of such lesions.

Aim

The aim of this study is to describe the radiological features of lesions in which CCC is seen on core biopsy and to review the outcome.

Method

Mammograms of 33 cases with established CCC on core biopsy were reviewed and the radiological features, follow-up imaging and surgical excision histology (if performed) were collated.

Results

Thirty-three cases were reviewed. In 10/33 cases an associated benign histology was present. Twenty-three out of 33 patients demonstrated CCC alone on core biopsy, 14 with atypia and nine without. In 23/23 patients (100%), the radiological feature was indeterminate microcalcification (M3).

Nine patients with CCC have proceeded to surgical excision to date. The histology was upgraded to DCIS in two patients. Further excision data and follow-up of patients with CCC who did not undergo surgery will be presented.