Pleomorphic lobular carcinoma in situ of the breast: clinicopathological review of 47 cases

Abstract

Background Pleomorphic lobular carcinoma in situ (PLCIS) of the breast is a distinctive entity, and yet its behavior and management are unclear. The purpose of this study was to review a relatively large number of cases and to evaluate the risk of recurrence. Methods Cases of PLCIS (n=47) over a 12 year-period were reviewed. The clinical, radiologic and pathologic findings were recorded. Immunohistochemistry for estrogen receptor (ER), progesterone receptor (PR) and HER2 were performed. Results Thirty-one patients had no concurrent or past history of breast cancer, six (19.4%) of which had local recurrence. All tumors (4 invasive carcinoma and two PLCIS) were ipsilateral. Younger age at presentation was a high risk factor for local recurrence with mean and range of 52.5 (44, 59) vs. 60.6 (40, 81) years (p=0.03). Three of 31 patients were treated with radiation therapy (RT), none of which developed local recurrence. PLCIS had an adverse ER/PR/HER2 molecular profile with at least 41.2% of the cases overexpressing HER2. Moreover, at least 11.7% of the cases were triple negative. Conclusions This study included the largest number of patients that had no past or concurrent history of breast cancer with the longest clinical follow-up, providing an insight to the management practices and risk of recurrence from PLCIS.

Lobular neoplasia detected in MRI-guided core biopsy carries a high risk for upgrade: a study of 63 cases from four different institutions

“…The cells were considered large (grade III nuclei) when their size was at least four times larger than that of a mature lymphocyte. 19 Concurrent lesions that normally warrant surgical intervention were also recorded including flat epithelial atypia, ADH, papilloma, and radial scar.…”

Pleomorphic lobular carcinoma in situ: Current evidence and a systemic review

“…As observed above, the numbers of patients in these studies are not sufficient to lead to any solid conclusions. However, Downs-Kelley et al (26) and Khoury et al (27) and indicated that radiotherapy led to a lower recurrence rate in their case series. Furthermore, Khoury et al (27) noted that patients on hormone therapy contributed to half of the recurrence cases.…”

“…However, Downs-Kelley et al (26) and Khoury et al (27) and indicated that radiotherapy led to a lower recurrence rate in their case series. Furthermore, Khoury et al (27) noted that patients on hormone therapy contributed to half of the recurrence cases. This issue may need to be explored in larger well-designed prospective studies.…”

“…Khoury et al (27) report on a case series of 47 patients diagnosed with PLCIS followed up over a 12-year period. Within this group, the authors selected 31 patients with PCLIS in order to study the risk of local recurrence following excision.…”

“…Also of note is that of the 11 patients who received hormonal therapy, 3 developed local recurrences. Khoury et al (27) identified a statistically significant correlation between tumour recurrence and patient age in which the mean age for recurrence was 52.5 years compared to 60.6 years for those who did not develop recurrences (27). …”