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Is surgical excision necessary for the management of atypical lobular hyperplasia and lobular carcinoma in situ diagnosed on core needle biopsy?: a report of 38 cases and review of the literature.
Arch Pathol Lab Med. 2008 Jun; 132(6):979-83.AP

Abstract

CONTEXT

Both atypical lobular hyperplasia (ALH) and lobular carcinoma in situ (LCIS) have traditionally been considered to be risk factors for the development of invasive carcinoma and are followed by close observation. Recent studies have suggested that these lesions may represent true precursors with progression to invasive carcinoma. Due to the debate over the significance of these lesions and the small number of cases reported in the literature, the treatment for lobular neoplasia diagnosed by percutaneous core biopsy (PCB) remains controversial.

OBJECTIVE

To review our experience with pure LCIS or ALH diagnosed by PCB and correlate the radiologic findings and surgical excision diagnoses to develop management guidelines for lobular neoplasia diagnosed by PCB.

DESIGN

We searched the pathology database for patients who underwent PCB with a diagnosis of either pure LCIS or ALH and had subsequent surgical excision. We compared the core diagnoses with the surgical excision diagnoses and the radiologic findings.

RESULTS

Thirty-eight PCBs with a diagnosis of ALH (18 cases) or LCIS (20 cases) were identified. Carcinoma was present at excision in 1 (6%) of the ALH cases and in 2 (10%) of the LCIS cases. In summary, 8% (3/38) of PCBs diagnosed as lobular neoplasia (ALH or LCIS) were upgraded to carcinoma (invasive carcinoma or ductal carcinoma in situ) at excision.

CONCLUSIONS

Surgical excision is indicated for all PCBs diagnosed as ALH or LCIS, as a significant percentage will show carcinoma at excision.

Authors+Show Affiliations

Department of Pathology, New York University School of Medicine, New York, USA. joan.cangiarella@med.nyu.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

18517282

Citation

Cangiarella, Joan, et al. "Is Surgical Excision Necessary for the Management of Atypical Lobular Hyperplasia and Lobular Carcinoma in Situ Diagnosed On Core Needle Biopsy?: a Report of 38 Cases and Review of the Literature." Archives of Pathology & Laboratory Medicine, vol. 132, no. 6, 2008, pp. 979-83.
Cangiarella J, Guth A, Axelrod D, et al. Is surgical excision necessary for the management of atypical lobular hyperplasia and lobular carcinoma in situ diagnosed on core needle biopsy?: a report of 38 cases and review of the literature. Arch Pathol Lab Med. 2008;132(6):979-83.
Cangiarella, J., Guth, A., Axelrod, D., Darvishian, F., Singh, B., Simsir, A., Roses, D., & Mercado, C. (2008). Is surgical excision necessary for the management of atypical lobular hyperplasia and lobular carcinoma in situ diagnosed on core needle biopsy?: a report of 38 cases and review of the literature. Archives of Pathology & Laboratory Medicine, 132(6), 979-83. https://doi.org/10.1043/1543-2165(2008)132[979:ISENFT]2.0.CO;2
Cangiarella J, et al. Is Surgical Excision Necessary for the Management of Atypical Lobular Hyperplasia and Lobular Carcinoma in Situ Diagnosed On Core Needle Biopsy?: a Report of 38 Cases and Review of the Literature. Arch Pathol Lab Med. 2008;132(6):979-83. PubMed PMID: 18517282.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Is surgical excision necessary for the management of atypical lobular hyperplasia and lobular carcinoma in situ diagnosed on core needle biopsy?: a report of 38 cases and review of the literature. AU - Cangiarella,Joan, AU - Guth,Amber, AU - Axelrod,Deborah, AU - Darvishian,Farbod, AU - Singh,Baljit, AU - Simsir,Aylin, AU - Roses,Daniel, AU - Mercado,Cecilia, PY - 2007/12/14/accepted PY - 2008/6/4/pubmed PY - 2008/6/25/medline PY - 2008/6/4/entrez SP - 979 EP - 83 JF - Archives of pathology & laboratory medicine JO - Arch Pathol Lab Med VL - 132 IS - 6 N2 - CONTEXT: Both atypical lobular hyperplasia (ALH) and lobular carcinoma in situ (LCIS) have traditionally been considered to be risk factors for the development of invasive carcinoma and are followed by close observation. Recent studies have suggested that these lesions may represent true precursors with progression to invasive carcinoma. Due to the debate over the significance of these lesions and the small number of cases reported in the literature, the treatment for lobular neoplasia diagnosed by percutaneous core biopsy (PCB) remains controversial. OBJECTIVE: To review our experience with pure LCIS or ALH diagnosed by PCB and correlate the radiologic findings and surgical excision diagnoses to develop management guidelines for lobular neoplasia diagnosed by PCB. DESIGN: We searched the pathology database for patients who underwent PCB with a diagnosis of either pure LCIS or ALH and had subsequent surgical excision. We compared the core diagnoses with the surgical excision diagnoses and the radiologic findings. RESULTS: Thirty-eight PCBs with a diagnosis of ALH (18 cases) or LCIS (20 cases) were identified. Carcinoma was present at excision in 1 (6%) of the ALH cases and in 2 (10%) of the LCIS cases. In summary, 8% (3/38) of PCBs diagnosed as lobular neoplasia (ALH or LCIS) were upgraded to carcinoma (invasive carcinoma or ductal carcinoma in situ) at excision. CONCLUSIONS: Surgical excision is indicated for all PCBs diagnosed as ALH or LCIS, as a significant percentage will show carcinoma at excision. SN - 1543-2165 UR - https://www.unboundmedicine.com/medline/citation/18517282/Is_surgical_excision_necessary_for_the_management_of_atypical_lobular_hyperplasia_and_lobular_carcinoma_in_situ_diagnosed_on_core_needle_biopsy:_a_report_of_38_cases_and_review_of_the_literature_ DB - PRIME DP - Unbound Medicine ER -