scholarly journals The lobular neoplasia enigma: management and prognosis in a long follow-up case series

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Jasna Metovic ◽  
Simona Osella Abate ◽  
Fulvio Borella ◽  
Elena Vissio ◽  
Luca Bertero ◽  
...  
Keyword(s):  
Carcinoma In Situ ◽  
Breast Imaging ◽  
Ductal Carcinoma ◽  
Malignant Lesion ◽  
Case Series ◽  
Lobular Neoplasia ◽  
Aggressive Disease

Abstract Background Many oncologists debate if lobular neoplasia (LN) is a risk factor or an obligatory precursor of more aggressive disease. This study has three aims: (i) describe the different treatment options (surgical resection vs observation), (ii) investigate the upgrade rate in surgically treated patients, and (iii) evaluate the long-term occurrences of aggressive disease in both operated and unoperated patients. Methods A series of 122 patients with LN bioptic diagnosis and follow-up information were selected. Clinical, radiological, and pathological data were collected from medical charts. At definitive histology, either invasive or ductal carcinoma in situ was considered upgraded lesions. Results Atypical lobular hyperplasia (ALH), lobular carcinoma in situ (LCIS), and high-grade LN (HG-LN) were diagnosed in 44, 63, and 15 patients, respectively. The median follow-up was 9.5 years. Ninety-nine patients were surgically treated, while 23 underwent clinical-radiological follow-up. An upgrade was observed in 28/99 (28.3%). Age ≥ 54 years (OR 4.01, CI 1.42–11.29, p = 0.009), Breast Imaging-Reporting and Data System (BI-RADS) categories 4–5 (OR 3.76, CI 1.37–10.1, p = 0.010), and preoperatory HG-LN diagnosis (OR 8.76, 1.82–42.27, p = 0.007) were related to upgraded/aggressive disease. During follow-up, 8 patients developed an ipsilateral malignant lesion, four of whom were not initially operated (4/23, 17%). Conclusions BI-RADS categories 4–5, HG-LN diagnosis, and age ≥ 54 years were features associated with an upgrade at definitive surgery. Moreover, 17% of unoperated cases developed an aggressive disease, emphasizing that LN patients need close surveillance due to the long-term risk of breast cancer.

scholarly journals Long-term Follow-up of Pure Ductal Carcinoma in situ after Breast-Conserving Surgery

2019 ◽  
Vol 7 (2) ◽  
pp. 73-80
Author(s):  
Keong Won Yun ◽  
Jisun Kim ◽  
Jong Won Lee ◽  
Sae Byul Lee ◽  
Hee Jeong Kim ◽  
...  
Keyword(s):  
Ductal Carcinoma In Situ ◽  
Carcinoma In Situ ◽  
Ductal Carcinoma ◽  
Breast Conserving Surgery ◽  
Long Term Follow Up

External accelerated partial breast irradiation for ductal carcinoma in situ: long-term follow-up from a phase 3 randomized trial

2018 ◽  
Vol 105 (3) ◽  
pp. 205-209 ◽  
Author(s):  
Carlotta Becherini ◽  
Icro Meattini ◽  
Lorenzo Livi ◽  
Pietro Garlatti ◽  
Isacco Desideri ◽  
...  
Keyword(s):  
Carcinoma In Situ ◽  
Ductal Carcinoma ◽  
Accelerated Partial Breast Irradiation ◽  
Partial Breast Irradiation ◽  
Efficacy And Safety ◽  
Breast Irradiation ◽  
Phase 3

Introduction: For a long time, accelerated partial breast irradiation (APBI) effectiveness for ductal carcinoma in situ (DCIS) has been debated, due to conflicting published results. Recent encouraging data from phase 3 trials reopened new perspectives for this radiation approach. The aim of the present study was to analyze the long-term efficacy and safety results of the series of patients with DCIS enrolled in the APBI arm of the APBI-IMRT-Florence phase 3 trial (NCT02104895). Methods: Patients were treated in a phase 3 randomized trial comparing whole breast irradiation (50 Gy in 25 fractions to the whole breast, plus 10 Gy in 5 fractions to the tumor bed) to APBI (30 Gy in 5 nonconsecutive fractions) using the intensity-modulated radiotherapy technique. Results: Overall, 22 patients were treated in the APBI arm. Median age was 62 years (mean 59; range 42–75 years). At a median follow-up of 9.2 years (mean 8.8; range 3.8–12.1 years), no contralateral invasive/DCIS occurrence, distant metastasis, or breast cancer–related death were recorded. The 5- and 10-year local recurrence, distant metastasis–free survival, and breast cancer–specific survival were 100%. The 10-year overall survival rate was 90.9%. No late toxicity at 5 and 10 years was recorded. Conclusions: Waiting for pending studies and mature follow-up, we confirmed the efficacy and safety of APBI for low-risk DCIS.

scholarly journals Long term follow-up of women with ductal carcinoma in situ treated with breast-conserving surgery

Cancer ◽  
1999 ◽  
Vol 86 (9) ◽  
pp. 1757-1767 ◽  
Author(s):  
Kimberly J. Van Zee ◽  
Laura Liberman ◽  
Billur Samli ◽  
Katherine N. Tran ◽  
Beryl McCormick ◽  
...  
Keyword(s):  
Ductal Carcinoma In Situ ◽  
Carcinoma In Situ ◽  
Ductal Carcinoma ◽  
Breast Conserving Surgery ◽  
Long Term Follow Up

Predicting relapse in ductal carcinoma in situ patients: an analysis of biologic markers with long-term follow-up

2007 ◽  
Vol 194 (4) ◽  
pp. 504-506 ◽  
Author(s):  
Tina J. Hieken ◽  
John Cheregi ◽  
Miguel Farolan ◽  
Joan Kim ◽  
Josè M. Velasco
Keyword(s):  
Ductal Carcinoma In Situ ◽  
Carcinoma In Situ ◽  
Ductal Carcinoma ◽  
Biologic Markers ◽  
Long Term Follow Up

scholarly journals Isolated Atypical Lobular Hyperplasia Diagnosed on Breast Biopsy: Low Upgrade Rate on Subsequent Excision With Long-Term Follow-up

2017 ◽  
Vol 142 (3) ◽  
pp. 391-395 ◽  
Author(s):  
Kristen E. Muller ◽  
Emily Roberts ◽  
Lili Zhao ◽  
Julie M. Jorns
Keyword(s):  
Breast Carcinoma ◽  
Carcinoma In Situ ◽  
Breast Biopsy ◽  
Ductal Carcinoma ◽  
Atypical Lobular Hyperplasia ◽  
Long Term Follow Up ◽  
History Of

Context.— The upgrade rate to carcinoma on excision for atypical lobular hyperplasia diagnosed on breast biopsy is controversial. Objective.— To review cases with isolated atypical lobular hyperplasia on biopsy to establish the rate of upgrade on excision and correlate with long-term follow-up. Design.— A database search was performed for 191 months to identify breast core biopsies with isolated atypical lobular hyperplasia. Cases with other atypical lesions in the biopsy or discordant radiologic-pathologic findings were excluded. Invasive carcinoma and ductal carcinoma in situ were considered upgraded pathology on excision. Patients without and with a history of, or concurrent diagnosis of, breast carcinoma were compared. Results.— Eighty-seven cases of isolated atypical lobular hyperplasia on biopsy underwent subsequent excision, which resulted in 3 upgraded cases (3.4%). All 3 cases with immediate upgrades revealed ductal carcinoma in situ. Upgrade was higher in patients with a concurrent diagnosis of breast carcinoma (2 of 26 and 1 of 61; 7.7% versus 1.6%, respectively). Follow-up information was available for 63 patients (57.8 ± 43.9 months; range, 6–183 months). Overall, 13% of patients without a history of breast carcinoma had a future breast cancer event, with the majority (83%) presenting in the contralateral breast. Conclusions.— With careful radiologic-pathologic correlation, the upgrade rate for isolated atypical lobular hyperplasia on biopsy is low, and a more conservative approach may be appropriate.

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