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Lobular neoplasia on core needle biopsy does not require excision.
Cancer. 2008 May 15; 112(10):2152-8.C

Abstract

BACKGROUND

Lobular neoplasia (LN), encompassing atypical lobular hyperplasia (ALH) and lobular carcinoma in situ (LCIS), is often an incidental finding on core needle biopsies (CNBs) performed in instances of radiologic densities and/or calcifications. Because LN is generally considered a risk factor for breast carcinoma, the utility of subsequent excision is controversial.

METHODS

The authors' database yielded 98 cases of LCIS and/or ALH. Cases containing LN accompanied by a second lesion mandating excision (eg, radial scar, atypical ductal hyperplasia [ADH]) and those failing to meet strict diagnostic criteria for LN (eg, atypical cells, mitoses, single-cell necrosis) were excluded. Radiographic calcifications were correlated with their histologic counterparts in terms of size, number, and pattern.

RESULTS

Ninety-one biopsies were performed for calcifications and 7 were performed for mass lesions. The ages of the patients ranged from 35 to 82 years. Fifty-three patients were followed radiologically without excision, 42 of whom had available clinicoradiologic information. The 45 patients who underwent excision were without disease at follow-up periods ranging from 1 to 8 years. Of these 45 patients, 42 (93%) had biopsy results demonstrating only LN. The remaining 3 patients had biopsies with the following findings: ADH in 1 biopsy, residual LCIS and a separate minute focus of infiltrating lobular carcinoma (clearly an incidental finding) in the second biopsy, and ductal carcinoma in situ admixed with LCIS in the third biopsy (a retrospective examination performed by 2 blinded breast pathologists revealed foci of atypical cells and mitoses).

CONCLUSIONS

Excision of LN is unnecessary provided that: 1) careful radiographic-pathologic correlation is performed; and 2) strict histologic criteria are adhered to when making the diagnosis. Close radiologic and clinical follow-up is adequate.

Authors+Show Affiliations

Lillian and Henry Stratton/Hans Popper Department of Pathology, Mount Sinai School of Medicine, New York, New York 10029, USA. nagic01@yahoo.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

18348299

Citation

Nagi, Chandandeep S., et al. "Lobular Neoplasia On Core Needle Biopsy Does Not Require Excision." Cancer, vol. 112, no. 10, 2008, pp. 2152-8.
Nagi CS, O'Donnell JE, Tismenetsky M, et al. Lobular neoplasia on core needle biopsy does not require excision. Cancer. 2008;112(10):2152-8.
Nagi, C. S., O'Donnell, J. E., Tismenetsky, M., Bleiweiss, I. J., & Jaffer, S. M. (2008). Lobular neoplasia on core needle biopsy does not require excision. Cancer, 112(10), 2152-8. https://doi.org/10.1002/cncr.23415
Nagi CS, et al. Lobular Neoplasia On Core Needle Biopsy Does Not Require Excision. Cancer. 2008 May 15;112(10):2152-8. PubMed PMID: 18348299.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Lobular neoplasia on core needle biopsy does not require excision. AU - Nagi,Chandandeep S, AU - O'Donnell,James E, AU - Tismenetsky,Mikhail, AU - Bleiweiss,Ira J, AU - Jaffer,Shabnam M, PY - 2008/3/19/pubmed PY - 2008/6/5/medline PY - 2008/3/19/entrez SP - 2152 EP - 8 JF - Cancer JO - Cancer VL - 112 IS - 10 N2 - BACKGROUND: Lobular neoplasia (LN), encompassing atypical lobular hyperplasia (ALH) and lobular carcinoma in situ (LCIS), is often an incidental finding on core needle biopsies (CNBs) performed in instances of radiologic densities and/or calcifications. Because LN is generally considered a risk factor for breast carcinoma, the utility of subsequent excision is controversial. METHODS: The authors' database yielded 98 cases of LCIS and/or ALH. Cases containing LN accompanied by a second lesion mandating excision (eg, radial scar, atypical ductal hyperplasia [ADH]) and those failing to meet strict diagnostic criteria for LN (eg, atypical cells, mitoses, single-cell necrosis) were excluded. Radiographic calcifications were correlated with their histologic counterparts in terms of size, number, and pattern. RESULTS: Ninety-one biopsies were performed for calcifications and 7 were performed for mass lesions. The ages of the patients ranged from 35 to 82 years. Fifty-three patients were followed radiologically without excision, 42 of whom had available clinicoradiologic information. The 45 patients who underwent excision were without disease at follow-up periods ranging from 1 to 8 years. Of these 45 patients, 42 (93%) had biopsy results demonstrating only LN. The remaining 3 patients had biopsies with the following findings: ADH in 1 biopsy, residual LCIS and a separate minute focus of infiltrating lobular carcinoma (clearly an incidental finding) in the second biopsy, and ductal carcinoma in situ admixed with LCIS in the third biopsy (a retrospective examination performed by 2 blinded breast pathologists revealed foci of atypical cells and mitoses). CONCLUSIONS: Excision of LN is unnecessary provided that: 1) careful radiographic-pathologic correlation is performed; and 2) strict histologic criteria are adhered to when making the diagnosis. Close radiologic and clinical follow-up is adequate. SN - 0008-543X UR - https://www.unboundmedicine.com/medline/citation/18348299/Lobular_neoplasia_on_core_needle_biopsy_does_not_require_excision_ L2 - https://doi.org/10.1002/cncr.23415 DB - PRIME DP - Unbound Medicine ER -