A Case Report: Lobular Carcinoma In Situ in a Male Patient with Subsequent Invasive Ductal Carcinoma Identified on Screening Breast MRI

The diagnosis via core needle biopsy of concurrent ductal carcinoma in situ and lobular carcinoma in situ within an enlarging previously biopsied benign fibroadenoma in women in their 40s is rare. Several case reports have described the occurrence of malignant changes within fibroadenomas, usually as an incidental finding following excision, and few reports have documented the transition of a fibroadenoma to malignancy. The current case report emphasises the importance of re-biopsying enlarging fibroadenomas, even with otherwise maintained benign appearing features on imaging, in women in their 40s, in order to exclude the possibility of malignancy.

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Lobular Neoplasia of the Breast: An Update

Archives of Pathology & Laboratory Medicine ◽

10.5858/133.7.1116 ◽

2009 ◽

Vol 133 (7) ◽

pp. 1116-1120 ◽

Cited By ~ 1

Author(s):

Alejandro Contreras ◽

Husain Sattar

Keyword(s):

Carcinoma In Situ ◽

Ductal Carcinoma ◽

Lobular Carcinoma ◽

Lobular Neoplasia ◽

Therapeutic Interventions ◽

High Grade ◽

Lobular Carcinoma In Situ ◽

Molecular Studies ◽

Pleomorphic Lobular Carcinoma

Abstract Context.—Lobular neoplasias (LNs) of the breast include atypical lobular neoplasia and lobular carcinoma in situ. Recent evidence suggests that LN is not only a risk factor for invasive lobular carcinoma, but is also a nonobligate precursor. Pleomorphic lobular carcinoma in situ (PLCIS) is a subtype of LN that has high-grade nuclei and other features that may mimic high-grade ductal carcinoma in situ. The management and follow-up of patients diagnosed with LN on core biopsy is a current issue of debate. However, recent genomic and molecular studies have identified candidate genes that may be important in understanding the pathogenesis of atypical lobular neoplasia and lobular carcinoma in situ, and thus may lead to other therapeutic interventions. Objective.—To review the literature on LN of the breast and discuss current issues in the diagnosis and management of this entity, with particular attention to the relatively newly recognized lesion PLCIS. Because the management of PLCIS varies from the other LN lesions, the recognition of PLCIS by the pathologist is necessary. Current issues in the molecular pathogenesis of LN are also presented. Data Sources.—Extensive review of the literature. Hematoxylin-eosin–stained and immunohistochemical-stained tissue from the author's personal collection. Conclusions.—Although morphology and immunohistochemical stains, such as E-cadherin, are important in the diagnosis and understanding of LN, genomic and molecular studies may guide the way these lesions are handled in the future. Recognizing PLCIS is important both for patient management and for our future understanding of LN pathogenesis.

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Risk of Contralateral Breast Cancer in Women with Ductal Carcinoma In Situ Associated with Synchronous Ipsilateral Lobular Carcinoma In Situ

Annals of Surgical Oncology ◽

10.1245/s10434-019-07796-9 ◽

2019 ◽

Vol 26 (13) ◽

pp. 4317-4325

Author(s):

Megan E. Miller ◽

Shirin Muhsen ◽

Emily C. Zabor ◽

Jessica Flynn ◽

Cristina Olcese ◽

...

Keyword(s):

Breast Cancer ◽

Ductal Carcinoma In Situ ◽

Carcinoma In Situ ◽

Contralateral Breast Cancer ◽

Ductal Carcinoma ◽

Lobular Carcinoma ◽

Contralateral Breast ◽

Lobular Carcinoma In Situ

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Pleomorphic lobular carcinoma in situ: A distinct entity of controversial significance.

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.27_suppl.177 ◽

2012 ◽

Vol 30 (27_suppl) ◽

pp. 177-177

Author(s):

Marina De Brot ◽

Shirin Muhsen ◽

Victor P. Andrade ◽

Starr Koslow Mautner ◽

Melissa Murray ◽

...

Keyword(s):

Breast Cancer ◽

Carcinoma In Situ ◽

Ductal Carcinoma ◽

Lobular Carcinoma ◽

Previous History ◽

Prior History ◽

Lobular Carcinoma In Situ ◽

Pleomorphic Lobular Carcinoma ◽

History Of

177 Background: Pleomorphic lobular carcinoma in situ (PLCIS) is an increasingly diagnosed variant of lobular carcinoma in situ. Histologically, it resembles ductal carcinoma in situ (DCIS), leading to controversy over proper management. Yet, the natural history of PLCIS is unknown. Here we describe our experience with PLCIS. Methods: Review of pathology reports (1995–2012) identified 233 cases of LCIS variants. Patients with synchronous ipsilateral DCIS or invasive cancer (IC) were excluded leaving 25 cases for review. Consensus review by 3 pathologists further excluded 7; leaving 18 cases, 12 of which were classified as PLCIS and 6 as LCIS with pleomorphic features (LCIS-PF). (Table) PLCIS was defined by cellular dyshesion, nuclear pleomorphism with a 2-3 fold size variation, conspicuous nucleoli, mitoses and abundant cytoplasm; lesions not meeting all parameters were classified as LCIS-PF. Loss of e-cadherin was confirmed; clinical data were obtained from medical records. Results: Mean patient age at diagnosis of PLCIS/LCIS-PF was 57 yrs (42-67 yrs). All cases presented with imaging abnormalities. A previous history of breast cancer was present in 7/18 (39%) pts (3/7, ipsilateral; 4/7, contralateral). Following PLCIS/LCIS-PF diagnosis, 6/18 (33%) pts underwent mastectomy and 12/18 had excision alone, with (n=3) or without chemoprevention (n=9). Margin status was negative in 4/12 pts; close in 3/12 pts and positive in 5/12 pts undergoing excision. At a median follow-up of 27 mos (2-148 mos), 2/12 pts treated with excision developed ipsilateral breast cancer (1 DCIS; 1 IC). Both had close margins at initial excision; median time to cancer, 54 mos. Conclusions: Pure PLCIS is an uncommon lesion. Synchronous malignancy or prior history of breast cancer are often present in patients with PLCIS, contributing to the difficulty in determining the actual risk conferred by this lesion and appropriate management. Efforts to systematically characterize LCIS variants and prospective documentation of outcomes are needed to clarify the significance of these lesions. [Table: see text]

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Ductal Carcinoma in situ and Lobular Carcinoma in situ Arising in a Phyllodes Tumor

Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) ◽

10.3919/jjsa.76.693 ◽

2015 ◽

Vol 76 (4) ◽

pp. 693-698

Author(s):

Yoshiaki NAKANO ◽

Toshio NISHI ◽

Ayaka NISHIMAE ◽

Masaru YAMASAKI ◽

Tetsuya YOSHIDA ◽

...

Keyword(s):

Ductal Carcinoma In Situ ◽

Carcinoma In Situ ◽

Ductal Carcinoma ◽

Lobular Carcinoma ◽

Phyllodes Tumor ◽

Lobular Carcinoma In Situ

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Efficacy of breast MRI for surgical decision in patients with breast cancer: ductal carcinoma in situ versus invasive ductal carcinoma

BMC Cancer ◽

10.1186/s12885-020-07443-7 ◽

2020 ◽

Vol 20 (1) ◽

Cited By ~ 1

Author(s):

Jeeyeon Lee ◽

Jin Hyang Jung ◽

Wan Wook Kim ◽

Chan Sub Park ◽

Ryu Kyung Lee ◽

...

Keyword(s):

Breast Cancer ◽

Invasive Ductal Carcinoma ◽

Ductal Carcinoma In Situ ◽

Carcinoma In Situ ◽

Ductal Carcinoma ◽

Breast Mri ◽

Positive Margin ◽

Breast Conserving Surgery ◽

Partial Mastectomy

Abstract Background Preoperative breast magnetic resonance imaging (MRI) provides more information than mammography and ultrasonography for determining the surgical plan for patients with breast cancer. This study aimed to determine whether breast MRI is more useful for patients with ductal carcinoma in situ (DCIS) lesions than for those with invasive ductal carcinoma (IDC). Methods A total of 1113 patients with breast cancer underwent mammography, ultrasonography, and additional breast MRI before surgery. The patients were divided into 2 groups: DCIS (n = 199) and IDC (n = 914), and their clinicopathological characteristics and oncological outcomes were compared. Breast surgery was classified as follows: conventional breast-conserving surgery (Group 1), partial mastectomy with volume displacement (Group 2), partial mastectomy with volume replacement (Group 3), and total mastectomy with or without reconstruction (Group 4). The initial surgical plan (based on routine mammography and ultrasonography) and final surgical plan (after additional breast MRI) were compared between the 2 groups. The change in surgical plan was defined as group shifting between the initial and final surgical plans. Results Changes (both increasing and decreasing) in surgical plans were more common in the DCIS group than in the IDC group (P < 0.001). These changes may be attributed to the increased extent of suspicious lesions on breast MRI, detection of additional daughter nodules, multifocality or multicentricity, and suspicious findings on mammography or ultrasonography but benign findings on breast MRI. Furthermore, the positive margin incidence in frozen biopsy was not different (P = 0.138). Conclusions Preoperative breast MRI may provide more information for determining the surgical plan for patients with DCIS than for those with IDC.

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