Article

Lobular Neoplasia in Breast Core Needle Biopsy Specimens Is Associated With a Low Risk of Ductal Carcinoma in Situ or Invasive Carcinoma on Subsequent Excision

Department of Pathology, Baptist Hospital of Miami, Miami, FL 33176, USA.
American Journal of Clinical Pathology (Impact Factor: 3.01). 09/2006; 126(2):310-3. DOI: 10.1309/GT45-3DBM-LRNP-NKL2
Source: PubMed

ABSTRACT To address the significance of lobular neoplasia (LN) in breast core needle biopsy specimens, we prospectively obtained LN cases and correlated results of subsequent tissue sampling. LN was diagnosed by core needle biopsy in 467 women; in 101 (21.6%), invasive carcinoma (IC) or ductal carcinoma in situ (DCIS) was diagnosed concurrently. Two patients (0.4%) had previous diagnoses of IC or DCIS, and 17 (3.6%) had a concurrent diagnosis of contralateral IC or DCIS. Of 366 patients without a concurrent diagnosis of IC or DCIS, subsequent tissue diagnoses were available for 156 cases (42.6%). Of 60 cases of LN and atypical ductal hyperplasia on the biopsy, 5 had IC and 10 had DCIS on the excision (total, 25%). Of 4 women with LN and a mucocele-like lesion on the biopsy, none had IC or DCIS on excision. Of 92 with LN alone on the biopsy, 7 had IC (6) or DCIS (1) on excision. Two cases were in sites away from the biopsy site, 3 in subsequent excisions of the biopsy site, and 2 after previous excision of the biopsy site without finding IC or DCIS. Although LN is associated with a high overall rate of IC and DCIS (30%), excision of the biopsy site for women with LN alone on core needle biopsy has a very low rate of IC and DCIS in our center. Women in whom biopsy sites are excised are still at risk for subsequent DCIS and IC.

0 Followers
 · 
93 Views
  • Source
    • "ommon and accounts for less than 2% of core biopsies in most series. While cases of ALH and LCIS identified at surgical excision are managed conservatively by clinical and radiologic follow-up, management guidelines for ALH and LCIS diagnosed at percutaneous core biopsy remain more controversial. While some studies find excision to be unnecessary (Renshaw AA et al. Am J Clin Pathol 2006.) the great majority of studies recommended surgical excision. Some recommended excision only for LCIS (not ALH), for LCIS with residual microcalcifications (Berg WA et al.) , LCIS with mass lesion (Middleton LP et al.), LCIS with associated high risk lesion, pleomorphic LCIS and cases of diagnostic confusion with DCIS (Bowman K et al.)"
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Verification of clinical procedure in patients with primary diagnosis of lobular carcinoma in situ and atypical lobular hyperplasia found on the basis of 11-gauge mammotomic biopsy. A retrospective evaluation of 4326 mammotomic biopsies carried out in one clinic by three oncological surgeons in view of the diagnosed lobular carcinoma in situ or atypical lobular hyperplasia without concomitant invasive lesions. Biopsies showed that lobular carcinoma in situ or atypical lobular hyperplasia were concomitant lesions with benign changes of the mammary gland. Of 16 cases of lobular carcinoma in situ, invasive ductal cancer was observed in 2 patients, invasive lobular cancer in 2 patients, and ductal carcinoma in situ in 1 case. Seven patients did not undergo surgery but were kept under intensive oncological supervision. Of 17 cases of atypical lobular hyperplasia, after surgery it turned out that there were 4 cases of invasive ductal cancer and 1 case of ductal carcinoma in situ. Five patients did not undergo surgery but were kept under intensive oncological supervision. After initial mammotomic diagnosis of lobular carcinoma in situ, invasive carcinoma or ductal carcinoma in situ was found in 31.25% of the cases and atypical lobular hyperplasia in 29.4%. This suggests that lobular neoplasia on core needle biopsy should prompt surgery. The open question is what factors are associated with the lower probability of concomitant invasive cancer. It seems that for isolated microcalcifications, which are totally removed in core biopsy, we can offer a close follow-up. We will have to wait for a follow-up longer than 2 years to be sure that surveillance is recommended for totally removed isolated microcalcifications.
    Tumori 95(1):32-5. · 1.09 Impact Factor
Show more

Preview

Download
0 Downloads
Available from