A clinicopathological study of fibroadenomas with epithelial proliferation including lobular carcinoma in-situ, atypical ductal hyperplasia, DCIS and invasive carcinoma

2019 ◽  
Vol 38 (3-4) ◽  
pp. 97-101
Author(s):  
Kritika Krishnamurthy ◽  
Sarah Alghamdi ◽  
Sylvia Gyapong ◽  
Stuart Kaplan ◽  
Robert J. Poppiti
Keyword(s):  
Carcinoma In Situ ◽  
Invasive Carcinoma ◽  
Atypical Ductal Hyperplasia ◽  
Lobular Carcinoma ◽  
Epithelial Proliferation ◽  
Lobular Carcinoma In Situ ◽  
Ductal Hyperplasia ◽  
Clinicopathological Study

Management of atypical lobular hyperplasia, atypical ductal hyperplasia, and lobular carcinoma in situ

2016 ◽  
Vol 16 (3) ◽  
pp. 335-346 ◽  
Author(s):  
Paola Clauser ◽  
Maria A. Marino ◽  
Pascal A.T. Baltzer ◽  
Massimo Bazzocchi ◽  
Chiara Zuiani
Keyword(s):  
Carcinoma In Situ ◽  
Atypical Ductal Hyperplasia ◽  
Lobular Carcinoma ◽  
Lobular Carcinoma In Situ ◽  
Atypical Lobular Hyperplasia ◽  
Ductal Hyperplasia

Advocating Nonsurgical Management of Patients With Small, Incidental Radial Scars at the Time of Needle Core Biopsy: A Study of 77 Cases

2015 ◽  
Vol 139 (9) ◽  
pp. 1137-1142 ◽  
Author(s):  
Cathleen Matrai ◽  
Timothy M. D'Alfonso ◽  
Lindsay Pharmer ◽  
Michele B. Drotman ◽  
Rache M. Simmons ◽  
...  
Keyword(s):  
Ductal Carcinoma In Situ ◽  
Core Biopsy ◽  
Carcinoma In Situ ◽  
Invasive Carcinoma ◽  
Ductal Carcinoma ◽  
Lobular Carcinoma ◽  
Radial Scar ◽  
Needle Core Biopsy ◽  
Ductal Hyperplasia

Context Radial scars are benign sclerosing lesions that are routinely excised when diagnosed in a needle core biopsy. Optimal management for patients with incidental and small (≤5 mm) radial scars is uncertain. Objective To assess pathologic upgrade of radial scars diagnosed in needle core biopsy samples and identify a subset of patients who could benefit from conservative management. Design Patients with a diagnosis of radial scar in a needle core biopsy who underwent excision of the biopsied area were identified. Radial scars greater than 5 mm in size and those with coexisting atypia, carcinoma, and papillary lesions were excluded. After histologic-radiographic correlation, rates of pathologic upgrade were assessed. Results Seventy-seven radial scars diagnosed in 66 patients were included. Overall, 9 of 77 (12%) showed upgrade to a high-risk lesion (6 lobular carcinoma in situ, 2 atypical ductal hyperplasia, 1 atypical lobular hyperplasia), while none (0%) showed upgrade to invasive carcinoma or ductal carcinoma in situ. One of 22 incidental radial scars (4.5%) showed upgrade on excision versus 6 of 36 (16.7%) for radial scars considered to be the radiographic target (P = .23). Older age was associated with upgrade (P < .001). Conclusions No incidental or small (≤5 mm) radial scars excised revealed invasive carcinoma or ductal carcinoma in situ on excision. Provided there is good pathologic-radiologic concordance, it appears reasonable for these patients to be managed conservatively.

Minimal (≤0.1 cm) Invasive Carcinoma in Breast Core Needle Biopsies

2004 ◽  
Vol 128 (9) ◽  
pp. 996-999
Author(s):  
Andrew A. Renshaw
Keyword(s):  
Minimally Invasive ◽  
Carcinoma In Situ ◽  
Invasive Carcinoma ◽  
Ductal Carcinoma ◽  
Atypical Ductal Hyperplasia ◽  
Core Needle ◽  
Ductal Hyperplasia ◽  
Ductal Carcinomas ◽  
Invasive Carcinomas

Abstract Context.—Although minimally invasive (microinvasive) carcinoma (≤0.1 cm) of the breast is a well-known and well-characterized entity in excision specimens, the significance of small foci of invasion in breast core needle biopsies has not been well described. Objective.—To define the significance of minimally invasive carcinoma in breast core needle biopsies. Design.—Review of a large series of core needle biopsies for invasive carcinomas measuring 0.1 cm or less and correlation of the results with those of subsequent excision. Setting.—Large community hospital. Results.—From approximately 8500 biopsies, a total of 18 cases of minimally invasive carcinoma from 16 women aged 42 to 80 years were identified. All were present on only 1 of 8 slides made from the block. Overall, the incidence was approximately 0.1% of all biopsies and 1% of all invasive carcinomas. Six cases were invasive lobular carcinomas, 1 was tubulolobular carcinoma, 3 were tubular carcinomas, and the remaining 8 were ductal carcinomas. Eight cases were associated with high-grade comedo ductal carcinomas, 2 with low-grade ductal carcinoma in situ, 3 with atypical ductal hyperplasia, 3 with atypical ductal hyperplasia and lobular carcinoma in situ, and 2 with no other lesion. From a total of 8 sections done entirely through the block, the lesion was present on the first level in 4 cases and the fifth level in 5 cases. No cases were identified in the last 3 levels. Subsequent pathology was available for 16 of the 18 cases. Invasive carcinomas measuring more than 1 cm were present in 9 cases (64%; along with 2 positive lymph nodes), invasive carcinomas less than 1 cm in 2 cases (14%), ductal carcinoma alone in 4 cases (29%), and no carcinoma in 1 case (7%). No pathologic or radiologic features were associated with the finding of invasive carcinoma at excision. Conclusion.—Invasive carcinoma measuring 0.1 cm or less is a rare finding in breast core needle biopsies, is commonly associated with in situ carcinomas and atypical hyperplasias, and is often associated with larger invasive foci at excision. However, invasive carcinomas smaller than 0.1 cm can occur without any other significant findings and may require relatively extensive sampling to identify.

scholarly journals Current Concepts in Diagnosis, Molecular Features, and Management of Lobular Carcinoma In Situ of the Breast With a Discussion of Morphologic Variants

2017 ◽  
Vol 141 (12) ◽  
pp. 1668-1678 ◽  
Author(s):  
Paula S. Ginter ◽  
Timothy M. D'Alfonso
Keyword(s):  
Breast Cancer ◽  
Carcinoma In Situ ◽  
Invasive Carcinoma ◽  
Lobular Carcinoma ◽  
Lobular Carcinoma In Situ ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Molecular Features ◽  
Increased Risk

Context.—Lobular carcinoma in situ (LCIS) refers to a neoplastic proliferation of cells that characteristically shows loss of E-cadherin expression and has long been regarded as a risk factor for invasive breast cancer. Long-term outcome studies and molecular data have also implicated LCIS as a nonobligate precursor to invasive carcinoma. In the past few decades, pleomorphic and florid LCIS have been recognized as morphologic variants of LCIS with more-aggressive histopathologic features, less-favorable biomarker profiles, and more-complex molecular features compared with classic LCIS. There is still a lack of consensus regarding certain aspects of managing patients with LCIS.Objectives.—To review recently published literature on LCIS and to provide an overview of the current morphologic classification of LCIS, recent molecular advances, and trends in patient management.Data Sources.—Sources included peer-reviewed, published journal articles in PubMed (US National Library of Medicine, Bethesda, Maryland) and published guidelines from the National Comprehensive Cancer Network (Fort Washington, Pennsylvania).Conclusions.—Lobular carcinoma in situ represents a marker for increased risk of breast cancer, as well as a nonobligate precursor to invasive carcinoma. Morphologic variants of LCIS—florid and pleomorphic LCIS—are genetically more-complex lesions and are more likely to be associated with invasive carcinoma. Further investigation into which molecular alterations in LCIS are associated with progression to invasive carcinoma is needed to help guide medical and surgical management.

scholarly journals Mucocele-like Lesion of the Breast Diagnosed on Core Biopsy: Histologic and Clinical Analysis of 78 Cases With Focus on Features Associated With Upgrade

2021 ◽  
Author(s):  
William S. Towne ◽  
Aya Y. Michaels ◽  
Paula S. Ginter
Keyword(s):  
Core Biopsy ◽  
Carcinoma In Situ ◽  
Invasive Carcinoma ◽  
Ductal Carcinoma ◽  
Atypical Ductal Hyperplasia ◽  
Clinical Analysis ◽  
Atypical Lobular Hyperplasia ◽  
Ductal Hyperplasia

Context.— Mucocele-like lesion of the breast (MLL) is an uncommon entity, and recent studies show low rates of upgrade from core needle biopsy (CNB) to excision. Objective.— To evaluate features associated with upgrade of MLLs diagnosed on CNB. Design.— Seventy-eight MLLs diagnosed on CNB from 1998–2019 and subsequent excisions were reviewed. Histologic parameters evaluated included the presence of atypia, presence and morphology of calcifications, and morphologic variant (classic [C-MLL], duct ectasia–like [DEL-MLL], or cystic mastopathy–like [CML-MLL]). Results.— Overall, 45 MLLs lacked atypia and 33 were associated with atypia (atypical ductal hyperplasia, 32; atypical lobular hyperplasia, 1). Most were C-MLLs (61) with fewer DEL-MLLs (14) and CML-MLLs (3). Half showed both coarse and fine calcifications, with fewer showing only coarse or fine calcifications, and some showing none. Subsequent excision or clinical follow-up was available for 25 MLLs without atypia—of which 2 (8.0%) were upgraded to ductal carcinoma in situ (DCIS)—and 23 with atypia, of which 4 (17.4%) were upgraded to DCIS. No cases were upgraded to invasive carcinoma. All upgraded cases showed coarse calcifications on CNB, and all upgraded cases were associated with residual calcifications on post-CNB imaging. Conclusions.— Most MLLs present as calcifications and nearly half are associated with atypia. Upgrade to DCIS is twice as frequent in MLLs with atypia versus those without. A predominance of coarse calcifications and the presence of residual targeted calcifications following core biopsy may be associated with higher upgrade rates.

scholarly journals Lobular Carcinoma in Situ During Preoperative Biopsy and the Rate of Upgrade

2021 ◽  
Author(s):  
Jeea Lee ◽  
Ga Yoon Ku ◽  
Haemin Lee ◽  
Hyung Seok Park ◽  
Ja Seung Ku ◽  
...  
Keyword(s):  
Progesterone Receptor ◽  
Carcinoma In Situ ◽  
Invasive Carcinoma ◽  
Lobular Carcinoma ◽  
Receptor Expression ◽  
Progesterone Receptor Expression ◽  
Lobular Carcinoma In Situ ◽  
Final Pathology ◽  
Preoperative Biopsy

Abstract Background: There is a potential risk that lobular carcinoma in situ (LCIS) on preoperative biopsy might be diagnosed as ductal carcinoma in situ (DCIS) or invasive carcinoma in the final pathology. This study aimed to evaluate the rate of upgrade of LCIS on preoperative biopsy to DCIS or invasive carcinoma.Methods: Data of 55 patients with LCIS on preoperative biopsy were analyzed. All patients underwent surgery between 1991 and 2016 at Severance Hospital in Seoul, Korea. We analyzed the rate of upgrade of preoperative LCIS to DCIS or invasive cancer in the final pathology. The clinicopathologic features related to the upgrade were evaluated.Results: The rate of upgrade of LCIS to DCIS or invasive carcinoma was 16.4% (9/55). In multivariate analysis, microcalcification and progesterone receptor expression were significantly associated with the upgrade of LCIS (P = 0.023 and 0.044, respectively).Conclusions: The current study showed a relatively high rate of upgrade of LCIS on preoperative biopsy to DCIS or invasive cancer. The presence of microcalcification and progesterone receptor expression may be potential predictors of upgradation of LCIS on preoperative biopsy. Surgical excision of the LCIS during preoperative biopsy could be a management option to identify the concealed malignancy.

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