The significance of lobular neoplasia on needle core biopsy of the breast

Department of Histopathology, Nottingham University Hospital, City Hospital Campus, Hucknall Road, Nottingham NG5 1PB, UK.
Archiv für Pathologische Anatomie und Physiologie und für Klinische Medicin (Impact Factor: 2.65). 06/2008; 452(5):473-9. DOI: 10.1007/s00428-008-0607-8
Source: PubMed


The management of a core biopsy diagnosis of lobular neoplasia is controversial. Detailed radiological-pathological review of 47 patients with cores showing classical lobular neoplasia was performed (patients with pleomorphic lobular carcinoma in situ (LCIS) or associated risk lesions were considered separately). Immediate surgical excision in 25 patients showed invasive carcinoma in 7, ductal carcinoma in situ (DCIS) in 1 and pleomorphic LCIS in 1; radiological-pathological review showed that the core biopsy missed a mass in 5, missed calcification in 2 and that calcification appeared adequately sampled in 2. Nineteen patients had follow-up of at least 2 years. Four patients developed malignancy at the site of the core biopsy (invasive carcinoma in three, DCIS in one); one carcinoma was mammographically occult, one patient had dense original mammograms and two had calcifications apparently adequately sampled by the core. In conclusion, most carcinomas identified at the site of core biopsy showing lobular neoplasia were the result of the core missing the radiological lesion, emphasising the importance of multidisciplinary review and investigation of any discordance. Some carcinomas were found after apparently adequate core biopsy, raising the question of whether excision biopsy should be considered after all core biopsy diagnoses of lobular neoplasia.

Download full-text


Available from: Andrew Evans, Dec 18, 2013
  • Source
    • "Hwang et al. 2008 [105] ND 277 87 (31.4) 5 (5.7) 4 (4.6) 9 (10.3) Menon et al. 2008 [106] 14,597 49 (0.3) 25 (51) 1 (4) 7 (28) 8 (32) Nagi et al. 2008 [56] "
    [Show abstract] [Hide abstract]
    ABSTRACT: Atypical ductal hyperplasia (ADH), flat epithelial atypia (FEA), and lobular neoplasia (LN) form a group of early precursor lesions that are part of the low-grade pathway in breast cancer development. This concept implies that the neoplastic disease process begins at a stage much earlier than in situ carcinoma. We have performed a review of the published literature for the upgrade risk to ductal carcinoma in situ or invasive carcinoma in open biopsy after a diagnosis of ADH, FEA, or LN in core needle biopsy. This has revealed the highest upgrade risk for ADH (28.2% after open biopsy), followed by LN (14.9%), and FEA (10.2%). With LN, the pleomorphic subtype is believed to confer a higher risk than classical LN. With all types of precursor lesions, careful attention must be paid to the clinicopathological correlation for the guidance of the clinical management. Follow-up biopsies are generally indicated in ADH, and if there is any radiological-pathological discrepancy, also in LN or FEA.
    Full-text · Article · Aug 2010 · Breast Care
  • Source

    Preview · Article ·
  • [Show abstract] [Hide abstract]
    ABSTRACT: A second-generation nondestructive evaluation (NDE) system that discriminates between different types of chemical munitions is under development. The NDE system extracts features from the acoustic spectra of known munitions, builds templates from these features, and performs classification by comparing features extracted from an unknown munition to a template library. Improvements over first-generation feature extraction, template construction and classification algorithms are reported. Results are presented on the performance of the system on a large data set collected from surrogate-filled munitions
    No preview · Conference Paper · Jan 1994
Show more