Question: I am a 53 year-old woman who gets yearly mammograms and my doctor told me I had some new “calcifications” and she wanted to biopsy them. My results showed “columnar cell change with atypia (flat epithelial atypia).” Now they say I need to have surgery to remove the area. I have looked this up and I don’t really understand what it means. Is this a pre-cancer?

Answer: Flat epithelial atypia is now the recommended term for a change in the ducts and lobules of the breast that used to be called a variety of things, including columnar cell change with atypia or CAPSS for example. We don’t know yet if this really is a precursor to cancer, but many studies have shown that when this finding is present in a core needle biopsy, many times there is a more significant finding on surgical excision, such as carcinoma in situ or even invasive carcinoma. Based on the research we have so far, most breast doctors are recommending removing the concerning area when a diagnosis like flat epithelial atypia is made by the pathologist.