Lobular carcinoma in situ of the breast: clinical, pathologic, and mammographic features.

Beute, B.J.; Kalisher, Lester; Hutter, R. V. P.

doi:10.2214/ajr.157.2.1853802

Cited by 76 publications

(65 citation statements)

References 5 publications

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“…National Surgical Breast and Bowel Project (NSABP) P-1 Breast Cancer Prevention Trial (BCPT) participants enrolled through the Puget Sound Oncology Consortium-Fred Hutchinson Cancer Research Center were contacted for participation in this study. BCPT enrolled 13,388 women ages z35 years between June 1, 1992, and September 30,1997. These women were randomized to receive 5 years of tamoxifen or placebo for the primary prevention of breast cancer.…”

Section: Methodsmentioning

confidence: 99%

Mammographic Density Correlation with Gail Model Breast Cancer Risk Estimates and Component Risk Factors

Palomares

Machia

Lehman

et al. 2006

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Background: The Gail model is a validated breast cancer risk assessment tool that is primarily based on nonmodifiable breast cancer risk factors. Conversely, mammographic breast density is strongly correlated with breast cancer risk and responds to risk-modifying interventions. The purpose of our study was to correlate mammographic density with breast cancer risk as calculated by the Gail model and to examine the relative association of each of the model covariates to mammographic density. Methods: The study included 99 participants of the National Surgical Breast and Bowel Project P-1 trial, ages 36 to 74 years, all of whom had a mammogram and Gail model risk estimates done upon trial entry. Baseline mammograms were retrieved and digitized, and mammographic density was assessed by both subjective and computer-assisted objective measures.

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Section: Methodsmentioning

confidence: 99%

Mammographic Density Correlation with Gail Model Breast Cancer Risk Estimates and Component Risk Factors

Palomares

Machia

Lehman

et al. 2006

Cancer Epidemiology, Biomarkers &Amp; Prevention

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“…9 Lobular neoplasia may be identified in breast core biopsies as an incidental finding associated with microcalcifications, mass lesion or indeterminate enhancement on imaging. With the advances in breast imaging and increasing use of MRI, the use of core biopsy has greatly increased and is the preferred method for the initial evaluation of most lesions.…”

mentioning

confidence: 99%

Classic lobular neoplasia on core biopsy: a clinical and radio-pathologic correlation study with follow-up excision biopsy

Chaudhary

Lawrence

McGinty³

et al. 2013

Modern Pathology

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There are no consensus guidelines for the management of lobular neoplasia diagnosed on core biopsy as the highest risk factor for cancer. This study aimed to assess the risk of upgrade (invasive carcinoma or ductal carcinoma in situ) at the site of the lobular neoplasia and any clinical, radiological or pathologic factors associated with the upgrade. We reviewed all cases with a diagnosis of lobular neoplasia on core biopsy from June 2006 to June 2011. Any cases with radio-pathologic discordance, coexistent lesion that required excision (atypical ductal hyperplasia, flat epithelial atypia, duct papilloma or radial scar) or non-classic variant of lobular carcinoma in situ (pleomorphic, mixed ductal and lobular, lobular carcinoma in situ with necrosis) were excluded from the study. Core biopsy indications included calcification in 35 (40%), non-mass like enhancement in 19 (22%), mass lesion in 31 (36%) and mass as well as calcification in two cases (2%). Follow-up excisions were studied for the presence of upgrade. The study cohort included 87 cases and showed an upgrade of 3.4% (95% confidence interval: 1-10%). Three cases showed an upgrade (one ductal carcinoma in situ and two invasive cancers). All upgraded cases were breast imaging-reporting and data system score Z4 and associated with atypical duct hyperplasia or in situ or invasive cancer in prior or concurrent biopsies in either breast. The number of cores and lobules involved, pagetoid duct involvement, presence of microcalcification in lobular neoplasia, needle gauge and number of cores obtained showed no correlation with the upgrade. Our results suggest that with radio-pathologic concordance and no prior biopsy proven risk for breast cancer, core biopsy finding of lobular neoplasia as the highest risk lesion can be appropriately and safely managed with clinical and radiologic follow-up as an alternative to surgical excision. Modern Pathology (2013) 26, 762-771; doi:10.1038/modpathol.2012 published online 11 January 2013 Keywords: atypical lobular hyperplasia; core biopsy; excision; follow-up; lobular carcinoma in situ; lobular neoplasia; upgrade Lobular neoplasia that includes atypical lobular hyperplasia and lobular carcinoma in situ was first described by Foote and Stewart in 1941 and later by Haagensen in 1978. 1,2 Lobular neoplasia are considered risk factors for subsequent invasive carcinoma in either breast with relative risk of 4 to 5 times for atypical lobular hyperplasia and up to 8 to 10 times for lobular carcinoma in situ. [3][4][5] The majority of breast cancers that subsequently developed were invasive ductal carcinoma. [3][4][5] Classic type lobular carcinoma in situ is defined as a monotonous, discohesive proliferation of small, round cells with low to intermediate nuclear grade, evenly spaced, that both fill and distend 450% of the acini of the involved lobular units. 6,7 Atypical lobular hyperplasia is defined as the same cell population but witho50% of the acini filled and distended. 6,7 Since classic atypical lobular hyperplasia and...

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“…were associated with calcifications, and 5% had a palpable mass. Although microcalcifi cations are a common indicator for biopsies in which LCIS is found, the calcifications are nearly always in adjacent sclerosing adenosis or apocrine metaplasia [53] and not in the LCIS [47,55]. When detected by biopsy of a suspicious mass, the mass is often focal fi brocystic disease [47] or fibroadenoma [53].…”

Section: Axillary Lymph Node Dissection (Alnd)mentioning

confidence: 99%

“…If the target of the biopsy was a mass or microcalcifications and LCIS is the only abnor mality found, the biopsy should be repeated, because LCIS is typically a mammographically occult process. This protocol is especially ap propriate because LCIS may coexist with DCIS and invasive cancer [53,56] At times, breast conservation may still be an option if all malignant tissue can be removed from both sites with clear margins [62]. CNB can also change surgical treatment when multiple masses prove malignant [63].…”

Section: Axillary Lymph Node Dissection (Alnd)mentioning

confidence: 99%

Treatment issues and core needle breast biopsy: clinical context.

Gundry

Berg²

1998

American Journal of Roentgenology

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Lobular carcinoma in situ of the breast: clinical, pathologic, and mammographic features.

Cited by 76 publications

References 5 publications

Mammographic Density Correlation with Gail Model Breast Cancer Risk Estimates and Component Risk Factors

Mammographic Density Correlation with Gail Model Breast Cancer Risk Estimates and Component Risk Factors

Classic lobular neoplasia on core biopsy: a clinical and radio-pathologic correlation study with follow-up excision biopsy

Treatment issues and core needle breast biopsy: clinical context.

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