Aims and objectives
“Lobular neoplasia” is a term that encompasses two entities,
atypical lobular hyperplasia (ALH) and lobular carcinoma in situ (LCIS).
The cells of both ALH and CLIS are small,
uniform,
discohesive,
and generally lack nucleoli.
The degree of involvement of the lobular units distinguishes these two entities,
and although some disagreement,
its widely accepted the definition by Page el al.
(1) ,
which sets that for LCIS it´s required that at least 50% of the acinar units in a lobule must be “filled and distended” by...
Methods and materials
Study population
We reviewed our database of all stereotactically (n=1204) and sonographically (n=978) vacuum assisted biopsy procedures performed in our hospital between January 2002 and December 2010.
We included in the study 53 lesions (52 patients) biopsied under stereotactic (n=43) and sonographic (n=10) VAB guidance in which LN (ALH and LCIS) was the most advanced lesion at pathologic examination.
All 53 lesions underwent surgical excision (n=33) or a minimum of 2 years´ imaging follow-up (n=20).
The patient´s age,
personal history of breast cancer,
clinical presentation...
Results
Of the 2182 vacuum-assisted biopsies,
53 yielded LN (2.4 %).
Of the 53 biopsies,
23 were ALH and 33 LCIS.
Forty-three of 53 LN were obtained under stereotactic guidance (81 %) and 10 under sonographic guidance (19 %).
Clinical Findings
The average patient age was 51 years (range,
35-73 years).
LN was found during the staging of a synchronous cancer in the contralateral breast in five patients and another four patients had a history of previous cancer in the other breast.
Thirteen patients had familial...
Conclusion
In this study of 53 vacuum-biopsied LN,
the underestimation rate was 1.9 % (1/53).
This underestimation rate suggests that a diagnosis of lobular neoplasia with vacuum-assisted biopsy may be safely managed with imaging follow-up rather than surgical excision.
References
1.
Page DL,
Dupont WD,
Rogers LW,
et al.
Atypical hyperplastic lesions of the female breast: a longterm follow-up study.
Cancer 1985; 55:2698–2708
2.
Simpson PT,
Gale T,
Fulford LG,
et al.
The diagnosis and management of pre-invasive breast disease: pathology of atypical lobular hyperplasia and lobular carcinoma in situ.
Breast Cancer Res2003; 5:258–262
3.
Li CI,
Daling JR,
Malone KE.
Age-specific incidence rates of in situ breast carcinomas by histologic type,
1980 to 2001.
Cancer Epidemiol Biomarkers Prev 2005;14(4): 1008–1011.
4.
Mulheron B,
Gray...