Factors Indicating Surgical Excision in Classical Type of Lobular Neoplasia of the Breast.

Atypical lobular hyperplasia B3 lesion Core needle biopsy High-risk lesion Lobular carcinoma in situ Lobular neoplasia Vacuum-assisted biopsy

Journal

Breast care (Basel, Switzerland)
ISSN: 1661-3791
Titre abrégé: Breast Care (Basel)
Pays: Switzerland
ID NLM: 101254060

Informations de publication

Date de publication:
Apr 2022
Historique:
received: 07 11 2020
accepted: 12 04 2021
entrez: 15 6 2022
pubmed: 16 6 2022
medline: 16 6 2022
Statut: ppublish

Résumé

Classical type of lobular neoplasia (LN) encompassing both atypical lobular hyperplasia and classical lobular carcinoma in situ of the breast is a lesion with uncertain malignant potential and has been the topic of several studies with conflicting outcome results. The aim of our study was to clarify outcome-relevant factors and treatment options of classical LN. We performed a pathological re-evaluation of the preoperative biopsy specimens and a retrospective clinical and radiological data analysis of 160 patients with LN from the Breast Center Zurich. Open surgery was performed in 65 patients, vacuum-assisted biopsy (VAB) in 79 patients, and surveillance after breast core needle biopsy (CNB) in 16 patients. The upgrade rate into ductal carcinoma in situ/invasive cancer was the highest in case of imaging/histology discordance (40%). If the number of foci in the biopsy specimen was ≥3, the upgrade rate in the consecutive surgical specimens was increased ( Surveillance or subsequent VAB after CNB of LN is sufficient in most cases. Careful consideration of individual radiological and histological factors is required to identify patients with a high risk of upgrade into malignancy. In those cases, surgical excision is indicated.

Identifiants

pubmed: 35702498
doi: 10.1159/000516609
pii: brc-0017-0121
pmc: PMC9149506
doi:

Types de publication

Journal Article

Langues

eng

Pagination

121-128

Informations de copyright

Copyright © 2021 by S. Karger AG, Basel.

Déclaration de conflit d'intérêts

All authors declare that they have no conflict of interest.

Références

Br J Cancer. 2007 Apr 23;96(8):1253-7
pubmed: 17438578
Cancer. 2006 May 15;106(10):2104-12
pubmed: 16604564
Ann Surg Oncol. 2007 Feb;14(2):704-11
pubmed: 17151788
Cancer. 2013 Mar 1;119(5):1073-9
pubmed: 23132235
Breast Cancer Res Treat. 2019 Apr;174(2):279-296
pubmed: 30506111
J Pathol. 2005 Jan;205(2):248-54
pubmed: 15641021
Am Surg. 2008 Feb;74(2):172-7
pubmed: 18306873
Surg Oncol Clin N Am. 2014 Jul;23(3):487-503
pubmed: 24882347
Breast Dis. 2016 Jan 25;36(1):5-14
pubmed: 27177338
Eur J Radiol. 2007 Feb;61(2):192-4
pubmed: 17164080
Breast. 2016 Jun;27:109-15
pubmed: 27060553
J Clin Pathol. 2007 Dec;60(12):1300-6
pubmed: 17630399
Am J Surg Pathol. 2000 Dec;24(12):1650-6
pubmed: 11117786
Lancet. 2000 Feb 26;355(9205):724-5
pubmed: 10703809
J Pathol. 2018 Apr;244(4):460-468
pubmed: 29344954
Arch Pathol Lab Med. 2019 May;143(5):621-627
pubmed: 30576240
Eur J Radiol. 2013 Mar;82(3):388-97
pubmed: 22483607
Int J Surg Pathol. 2007 Oct;15(4):369-75
pubmed: 17913943
Pathology. 2016 Jan;48(1):25-9
pubmed: 27020205
Am J Pathol. 1941 Jul;17(4):491-496.3
pubmed: 19970575
Eur Radiol. 2011 Jun;21(6):1200-6
pubmed: 21225267
Breast. 2016 Dec;30:125-129
pubmed: 27718416
Clin Radiol. 2019 Aug;74(8):653.e19-653.e25
pubmed: 31078275
BMC Cancer. 2018 Aug 16;18(1):829
pubmed: 30115017
Int J Environ Res Public Health. 2017 Apr 23;14(4):
pubmed: 28441745
Breast Cancer Res Treat. 2018 Apr;168(3):649-654
pubmed: 29299726
Ann Surg Oncol. 2012 Dec;19(13):4124-8
pubmed: 22847126
Nat Rev Clin Oncol. 2015 Apr;12(4):227-38
pubmed: 25622978
Radiology. 2013 Nov;269(2):340-7
pubmed: 23901123

Auteurs

Constanze Elfgen (C)

Breast Center Zurich, Zurich, Switzerland.
University of Witten-Herdecke, Witten, Germany.

Christoph Tausch (C)

Breast Center Zurich, Zurich, Switzerland.

Ann-Katrin Rodewald (AK)

Institute of Pathology and Molecular Pathology, University Hospital Zurich, Zurich, Switzerland.

Uwe Güth (U)

Breast Center Zurich, Zurich, Switzerland.
Faculty of Medicine, University of Basel, Basel, Switzerland.

Christoph Rageth (C)

Department of Gynecology and Obstetrics, Breast Center, Hôpitaux Universitaires de Genève, Geneva, Switzerland.

Vesna Bjelic-Radisic (V)

University of Witten-Herdecke, Witten, Germany.
Institute of Gynecology and Obstetrics, University Hospital Wuppertal, Wuppertal, Germany.

Markus Fleisch (M)

University of Witten-Herdecke, Witten, Germany.
Institute of Gynecology and Obstetrics, University Hospital Wuppertal, Wuppertal, Germany.

Claudia Kurtz (C)

Department of Radiology and Nuclear Medicine, Kantonsspital Luzern, Lucerne, Switzerland.

Jesus Gonzalez Diaz (J)

Faculty of Medicine, University of Zurich, Zurich, Switzerland.

Zsuzsanna Varga (Z)

Institute of Pathology and Molecular Pathology, University Hospital Zurich, Zurich, Switzerland.

Classifications MeSH