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When pathological and radiological correlation is achieved, excision of fibroadenoma with lobular neoplasia on core biopsy is not warranted.
Breast. 2016 Dec; 30:125-129.B

Abstract

BACKGROUND

The diagnosis and management of lobular neoplasia (LN) including lobular carcinoma in situ (LCIS) and atypical lobular hyperplasia (ALH) remains controversial. Current management options after a core needle biopsy (CNB) with lobular neoplasia (LN) incorporating both ALH and LCIS include excision biopsy or careful clinical and radiologic follow up.

METHODS

A retrospective analysis of the surgical database at Cork University Hospital was performed to identify all core needle biopsies from January 1st 2010 to 31st December 2013 with a diagnosis of FA who subsequently underwent surgical excision biopsy. All cases with associated LN including ALH and classical LCIS were selected. We excluded cases with coexistent ductal carcinoma in situ (DCIS), invasive carcinoma, LN associated with necrosis, pleomorphic lobular carcinoma in situ (PLCIS) or lesions which would require excision in their own right (papilloma, radial scar, atypical ductal hyperplasia (ADH) or flat epithelial atypia (FEA)). Cases in which the radiologic targeted mass was discordant with a diagnosis of FA were also excluded.

RESULTS

2878 consecutive CNB with a diagnosis of FA were identified. 25 cases had a diagnosis of concomitant ALH or classical LCIS. Our study cohort consisted of 21 women with a mean age 53 years (age range 41-70 years). The core biopsy diagnosis was of LCIS and FA in 16 cases and ALH and FA in 5 cases. On excision biopsy, a FA was confirmed in all 21 cases. In addition to the FA, residual LCIS was present in 14 cases with residual ALH in 2 cases. One of the twenty-one cases (4.8%) was upgraded to invasive ductal carcinoma on excision.

Authors+Show Affiliations

Cork University Hospital, Wilton, Cork, Ireland.Cork University Hospital, Wilton, Cork, Ireland. Electronic address: cathleen.oneill@gmail.com.Cork University Hospital, Wilton, Cork, Ireland.Cork University Hospital, Wilton, Cork, Ireland.Cork University Hospital, Wilton, Cork, Ireland.Cork University Hospital, Wilton, Cork, Ireland.Cork University Hospital, Wilton, Cork, Ireland.Cork University Hospital, Wilton, Cork, Ireland.Cork University Hospital, Wilton, Cork, Ireland.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27718416

Citation

Fives, C, et al. "When Pathological and Radiological Correlation Is Achieved, Excision of Fibroadenoma With Lobular Neoplasia On Core Biopsy Is Not Warranted." Breast (Edinburgh, Scotland), vol. 30, 2016, pp. 125-129.
Fives C, O'Neill CJ, Murphy R, et al. When pathological and radiological correlation is achieved, excision of fibroadenoma with lobular neoplasia on core biopsy is not warranted. Breast. 2016;30:125-129.
Fives, C., O'Neill, C. J., Murphy, R., Corrigan, M. A., O'Sullivan, M. J., Feeley, L., Bennett, M. W., O'Connell, F., & Browne, T. J. (2016). When pathological and radiological correlation is achieved, excision of fibroadenoma with lobular neoplasia on core biopsy is not warranted. Breast (Edinburgh, Scotland), 30, 125-129. https://doi.org/10.1016/j.breast.2016.09.006
Fives C, et al. When Pathological and Radiological Correlation Is Achieved, Excision of Fibroadenoma With Lobular Neoplasia On Core Biopsy Is Not Warranted. Breast. 2016;30:125-129. PubMed PMID: 27718416.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - When pathological and radiological correlation is achieved, excision of fibroadenoma with lobular neoplasia on core biopsy is not warranted. AU - Fives,C, AU - O'Neill,C J, AU - Murphy,R, AU - Corrigan,M A, AU - O'Sullivan,M J, AU - Feeley,L, AU - Bennett,M W, AU - O'Connell,F, AU - Browne,T J, Y1 - 2016/10/04/ PY - 2016/05/25/received PY - 2016/08/31/revised PY - 2016/09/11/accepted PY - 2016/10/9/pubmed PY - 2017/3/14/medline PY - 2016/10/9/entrez KW - Benign KW - Breast KW - Fibroadenoma KW - LCIS KW - Lobular carcinoma KW - Lobular neoplasia KW - Pathology KW - Surgery SP - 125 EP - 129 JF - Breast (Edinburgh, Scotland) JO - Breast VL - 30 N2 - BACKGROUND: The diagnosis and management of lobular neoplasia (LN) including lobular carcinoma in situ (LCIS) and atypical lobular hyperplasia (ALH) remains controversial. Current management options after a core needle biopsy (CNB) with lobular neoplasia (LN) incorporating both ALH and LCIS include excision biopsy or careful clinical and radiologic follow up. METHODS: A retrospective analysis of the surgical database at Cork University Hospital was performed to identify all core needle biopsies from January 1st 2010 to 31st December 2013 with a diagnosis of FA who subsequently underwent surgical excision biopsy. All cases with associated LN including ALH and classical LCIS were selected. We excluded cases with coexistent ductal carcinoma in situ (DCIS), invasive carcinoma, LN associated with necrosis, pleomorphic lobular carcinoma in situ (PLCIS) or lesions which would require excision in their own right (papilloma, radial scar, atypical ductal hyperplasia (ADH) or flat epithelial atypia (FEA)). Cases in which the radiologic targeted mass was discordant with a diagnosis of FA were also excluded. RESULTS: 2878 consecutive CNB with a diagnosis of FA were identified. 25 cases had a diagnosis of concomitant ALH or classical LCIS. Our study cohort consisted of 21 women with a mean age 53 years (age range 41-70 years). The core biopsy diagnosis was of LCIS and FA in 16 cases and ALH and FA in 5 cases. On excision biopsy, a FA was confirmed in all 21 cases. In addition to the FA, residual LCIS was present in 14 cases with residual ALH in 2 cases. One of the twenty-one cases (4.8%) was upgraded to invasive ductal carcinoma on excision. SN - 1532-3080 UR - https://www.unboundmedicine.com/medline/citation/27718416/When_pathological_and_radiological_correlation_is_achieved_excision_of_fibroadenoma_with_lobular_neoplasia_on_core_biopsy_is_not_warranted_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0960-9776(16)30167-9 DB - PRIME DP - Unbound Medicine ER -