Outcomes of classic lobular neoplasia diagnosed on breast core needle biopsy: a retrospective multi-center study.

Management of classic lobular neoplasia (cLN) diagnosed on core needle biopsy (CNB) is controversial. Our aim in this study was to review cases of cLN diagnosed on CNB to determine the rate and risk factors of an upgrade to ductal carcinoma in situ (DCIS) or invasive carcinoma on excision. All breas...

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Publicado en:Virchows Archiv: European Journal of Pathology Vol. 476; no. 2; pp. 209 - 218
Autores principales: Genco, Iskender Sinan, Tugertimur, Bugra, Chang, Qing, Cassell, Lauren, Hajiyeva, Sabina
Formato: research Journal Article
Publicado: Springer Nature Feb2020
Acceso en línea:Ver este registro en EBSCOhost
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      pub: Springer Nature
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        atl: Outcomes of classic lobular neoplasia diagnosed on breast core needle biopsy: a retrospective multi-center study.
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        au:
          Genco, Iskender Sinan
          Tugertimur, Bugra
          Chang, Qing
          Cassell, Lauren
          Hajiyeva, Sabina
        affil: Department of Pathology and Laboratory Medicine, Northwell Health Lenox Hill Hospital,, 100 E 77th Street, 10075, New York, NY, USA
      sug:
        subj:
          Carcinoma, Lobular Pathology
          Breast Neoplasms Diagnosis
          Biopsy, Needle Methods
          Breast Neoplasms Pathology
          Adult
          Breast Pathology
          Female
          Precancerous Conditions Pathology
          Adenocarcinoma Pathology
          Middle Age
          Aged, 80 and Over
          Aged
          Retrospective Design
          Carcinoma in Situ Pathology
          Carcinoma, Lobular Diagnosis
          Personal Resource Questionnaire
          Human
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Aged, 80 & over
          Aged: 65+ years
          Female
      ab: Management of classic lobular neoplasia (cLN) diagnosed on core needle biopsy (CNB) is controversial. Our aim in this study was to review cases of cLN diagnosed on CNB to determine the rate and risk factors of an upgrade to ductal carcinoma in situ (DCIS) or invasive carcinoma on excision. All breast CNBs with a diagnosis of atypical lobular hyperplasia (ALH) or classic lobular carcinoma in situ (cLCIS) from three different institutions within a single health care system between 2013 and 2018 were retrieved. Cases with any additional high-risk lesions in the same CNB or discordant radiological-pathological correlation were excluded. Information about age, personal history of prior or concurrent breast cancer (P/CBC), and radiological and histological findings were recorded. A total of 287 cLN cases underwent surgical excision. Analysis of these 287 cLN cases showed 11 (3.8%) upgrade lesions on excision. Among the 172 ALH cases, there were 3 (1.7%) upgrades, which were all invasive lobular carcinomas (ILCs). On the other hand, 8 of 115 (7%) cLCIS cases revealed upgrade on excision (2 ILC, 5 DCIS. and 1 ILC + DCIS). Statistical analysis revealed that cLN cases with P/CBC, radiological asymmetry, or architectural distortion had a statistically significant higher upgrade rate on excision. Our findings revealed a low upgrade rate (3.8%) on the excision of classic lobular neoplasia diagnosed on breast core needle biopsy. Clinicoradiological surveillance can be appropriate when lobular neoplasia is identified on core biopsy with pathological radiological concordance in patients without a history of breast cancer, with the caveat that radiological asymmetry and architectural distortion are associated with a significant increase in an upgrade on excision.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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