Lobular Neoplasia in Breast Core Needle Biopsy Specimens Is Not Associated With an Increased Risk of Ductal Carcinoma In Situ or Invasive Carcinoma

Renshaw, Andrew A.; Cartagena, Norberto; Derhagopian, Robert P.; Gould, Edwin W.

doi:10.1309/t4xf-c61j-c95y-vr4q

Cited by 74 publications

(24 citation statements)

References 6 publications

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“…Admittedly, by these criteria, a few cases of lobular carcinoma in situ involving fibroadenomas and lobular carcinoma in situ involving adenosis will be unnecessarily excised, but it is best to err on the side of caution when evaluating a mass lesion with an atypical lobular histology. Authors who have examined pure examples of lobular carcinoma in situ and atypical lobular hyperplasia and have correlated mammographic and clinical findings (4,15,17,22) have had similar findings. Again, we emphasize that cases of pleomorphic lobular carcinoma in situ and lobular carcinoma in situ with necrosis were specifically excluded from this study as we routinely recommend excision for these lobular carcinoma in situ variants.…”

Section: Discussionmentioning

confidence: 82%

Lobular Carcinoma In Situ Diagnosed By Core Needle Biopsy: When Should It Be Excised?

et al. 2003

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Core needle biopsy is the preferred technique for evaluating breast masses and abnormal mammographic findings. The frequency of detection of noninvasive lobular lesions by core needle biopsy is increasing. Historically, the diagnosis of lobular carcinoma in situ has been considered a risk factor for the development of invasive carcinoma, and treatment has consisted of careful clinical follow-up with or without chemopreventive therapeutic agents such as tamoxifen citrate. We retrospectively reviewed core needle biopsy material with the primary diagnoses of lobular carcinoma in situ, atypical lobular hyperplasia, and lobular neoplasia in conjunction with clinical and radiographic findings to make recommendations as to when excision may be merited. We searched our database for core needle biopsy cases with lobular carcinoma in situ, atypical lobular hyperplasia, and lobular neoplasia as the primary diagnosis. Microcalcifications had been sampled with a stereotactically guided, 11 G Mammotome biopsy device, and masses had been sampled with an ultrasound guided, 18 G core needle. Glass slides were reviewed and histological parameters assessed. Mammographic findings were reviewed, and clinical information was obtained from the medical record. When available, excisional biopsy material was reviewed. The 2337 breast core needle biopsies performed from January 1995 to December 2001 included 35 (1.5%) with classic lobular carcinoma in situ (14), lobular neoplasia (4), and atypical lobular hyperplasia (17) as the primary diagnosis. Twelve of these 35 cases (34%) had histological evidence of microcalcifications directly associated with the lobular carcinoma in situ, lobular neoplasia, atypical lobular hyperplasia. Radiologic review revealed 21 calcifications, 6 ultrasonographic masses, and 8 mammographic masses and/or architectural distortions. Excisional biopsy had been performed in 17 cases (49%). In six cases diagnosed as in situ on core needle biopsy, excisional biopsy revealed invasive carcinoma. All of these patients had radiographically detectable masses. Eleven cases had excisional biopsies that showed histology similar to that of the core needle biopsies. The most important predictor of invasive carcinoma on excision was a synchronous mass lesion. Lobular carcinoma in situ involving adenosis and lobular carcinoma in situ with pagetoid spread on core needle biopsies did not show a histologically more aggressive lesion on excision and, therefore, may not require additional surgery. Histologically identified calcifications were associated with lobular lesions 34% of the time; however, their presence inside an in situ lobular lesion did not portend worse pathology on re-excision and should not be a criterion for excision. Based on these findings, we recommend excisional biopsy of lobular carcinoma in situ, atypical lobular hyperplasia or lobular neoplasia only when it is associated with a synchronous mass lesion. The increased use of screening mammography has resulted in an increasing number of image-guided breast biop...

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Section: Discussionmentioning

confidence: 82%

Lobular Carcinoma In Situ Diagnosed By Core Needle Biopsy: When Should It Be Excised?

et al. 2003

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“…There was no increased risk of IBC in the site of lesion in subsequent surgical excision of LN diagnosed in biopsy in some studies [28][29][30]. On the contrary, in other series, the rate of LN upgraded to IBC or DCIS ranged from 17% to 42% [31][32][33][34][35][36].…”

Section: Methodsmentioning

confidence: 99%

Lobular neoplasia found on breast biopsy: marker of increased risk of malignancy or direct pre-cancerous lesion?

Szynglarewicz¹,

Matkowski²,

Hałoń³

et al. 2011

Folia Histochem Cytobiol.

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“…Some authors have previously suggested a conservative approach following a diagnosis of LN on CNB with annual examinations and mammographic surveillance [28,35,55,75,76]. Their conclusions are based on small retrospective studies.…”

Section: Conservative Approachmentioning

confidence: 99%

Management of lobular carcinoma in-situ and atypical lobular hyperplasia of the breast–A review

Hussain

Cunnick

2011

European Journal of Surgical Oncology

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To cite this version:M. Hussain, G.H. Cunnick. Management of lobular carcinoma in situ and atypical lobular hyperplasia of the breast -A review. EJSO -European Journal of Surgical Oncology, WB Saunders, 2011, 37 (4) This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.We are submitting the article "Management of Lobular Neoplasia in Situ and Atypical Lobular Hyperplasia -A Review" to your auspicious journal with your kind permission. We have made an effort in an attempt to address the management controversies surrounding lobular Neoplasia on reviewing the currently available literature and have made some management recommendations based on the evidence available.We have also declared no funding and no conflict of interest on the authors' form.Whilst, I (Mubashar Hussain) remain the first author for the paper, Mr G Cunnick could be kindly contacted for correspondence. malignancy. 29% of the unspecified LNs were upgraded to malignancy. The higher incidence of malignancy within excision specimens for LCIS and PLCIS compared to ALH was significant (P<0.04, <0.003 respectively). Conclusion:There is a significant under-estimation of malignancy in patients diagnosed with breast LN on CNB. 27% cases of CNB-diagnosed LN were found to contain malignancy following surgical excision. All patients diagnosed with LN on CNB should be considered for surgical excision biopsy.

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Lobular Neoplasia in Breast Core Needle Biopsy Specimens Is Not Associated With an Increased Risk of Ductal Carcinoma In Situ or Invasive Carcinoma

Cited by 74 publications

References 6 publications

Lobular Carcinoma In Situ Diagnosed By Core Needle Biopsy: When Should It Be Excised?

Lobular Carcinoma In Situ Diagnosed By Core Needle Biopsy: When Should It Be Excised?

Lobular neoplasia found on breast biopsy: marker of increased risk of malignancy or direct pre-cancerous lesion?

Management of lobular carcinoma in-situ and atypical lobular hyperplasia of the breast–A review

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