Lobular neoplasia on core biopsy: Is excision always indicated?

Autor:	K. M. Rosenkranz, C. A. Makarewich
Rok vydání:	2011
Předmět:	Cancer Research medicine.medical_specialty Percutaneous medicine.diagnostic_test business.industry Lobular carcinoma Atypical lobular hyperplasia medicine.disease Surgery Oncology Biopsy medicine Occult malignancy Single institution business Core biopsy Lobular Neoplasia
Zdroj:	Journal of Clinical Oncology. 29:75-75
ISSN:	1527-7755 0732-183X
DOI:	10.1200/jco.2011.29.27_suppl.75
Popis:	75 Background: Lobular neoplasia (LN) is a continuum of rare, noninvasive lesions of the breast including lobular carcinoma in situ and atypical lobular hyperplasia. Current management is controversial and often includes excisional biopsy in women diagnosed with LN on percutaneous core biopsy (PCB) to exclude an occult malignancy. This strategy is based on retrospective data in women undergoing selective excisions. We performed routine excision of all lesions diagnosed as LN in our institution in order to ascertain a more accurate assessment of pathologic upgrade. Methods: Retrospective review of all prospectively collected cases of LN treated in a single institution from 2007-2010. Excisional biopsies were performed in all cases of LN excepting one (patient declined). Histologic findings of excisional biopsies were reviewed to assess the rate of pathologic upgrade. Results: Of the 2,289 PCBs performed during the study period, LN was found in 23 cases (1.0%). Twenty two (0.96%) cases proceeded to excisional biopsy. On final pathology, malignancy was found in 4 patients (18%). Two of 22 (9%) women were upgraded to ductal carcinoma in situ (DCIS) (both intermediate grade with foci of Conclusions: While 18% of women in our series had upgraded pathology at the time of excisional biopsy, we support selective rather than routine excisional biopsy. One of the invasive diagnoses was an incidental finding unrelated to the microcalcifications for which biopsy was initially performed. In the second case of invasive disease, the upgraded lesion was a mass identified on MRI performed for surgical planning in a woman already diagnosed with breast cancer. In both cases of DCIS, the area of malignancy was small (
Databáze:	OpenAIRE
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