Authors: Menon, S.¹; Porter, G.²; Evans, A.²; Ellis, I.¹; Elston, C.¹; Hodi, Z.¹; Lee, A.³

Source: Virchows Archiv, Volume 452, Number 5, May 2008 , pp. 473-479(7)

Publisher: Springer

Abstract:

The management of a core biopsy diagnosis of lobular neoplasia is controversial. Detailed radiological-pathological review of 47 patients with cores showing classical lobular neoplasia was performed (patients with pleomorphic lobular carcinoma in situ (LCIS) or associated risk lesions were considered separately). Immediate surgical excision in 25 patients showed invasive carcinoma in 7, ductal carcinoma in situ (DCIS) in 1 and pleomorphic LCIS in 1; radiological-pathological review showed that the core biopsy missed a mass in 5, missed calcification in 2 and that calcification appeared adequately sampled in 2. Nineteen patients had follow-up of at least 2 years. Four patients developed malignancy at the site of the core biopsy (invasive carcinoma in three, DCIS in one); one carcinoma was mammographically occult, one patient had dense original mammograms and two had calcifications apparently adequately sampled by the core. In conclusion, most carcinomas identified at the site of core biopsy showing lobular neoplasia were the result of the core missing the radiological lesion, emphasising the importance of multidisciplinary review and investigation of any discordance. Some carcinomas were found after apparently adequate core biopsy, raising the question of whether excision biopsy should be considered after all core biopsy diagnoses of lobular neoplasia.

Keywords: Lobular neoplasia; Atypical lobular neoplasia; Lobular carcinoma in situ; Pleomorphic lobular carcinoma in situ; Needle biopsy; Breast

Document Type: Research article

DOI: http://dx.doi.org/10.1007/s00428-008-0607-8

Affiliations: 1: Department of Histopathology, Nottingham University Hospital, City Hospital Campus, Hucknall Road, Nottingham, NG5 1PB, UK 2: Department of Radiology, Nottingham University Hospital, City Hospital Campus, Nottingham, UK 3: Department of Histopathology, Nottingham University Hospital, City Hospital Campus, Hucknall Road, Nottingham, NG5 1PB, UK, Email: andrew.lee@nuh.nhs.uk

Publication date: 2008-05-01

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