European Radiology

, Volume 24, Issue 7, pp 1651–1658 | Cite as

Underestimation rate of lobular intraepithelial neoplasia in vacuum-assisted breast biopsy

  • Meroni Stefano
  • Bozzini Anna Carla
  • Pruneri Giancarlo
  • Moscovici Oana Codrina
  • Maisonneuve Patrick
  • Menna Simona
  • Penco Silvia
  • Meneghetti Lorenza
  • Renne Giuseppe
  • Cassano Enrico



To evaluate the underestimation rate and clinical relevance of lobular neoplasia in vacuum-assisted breast biopsy (VABB).


A total of 161 cases of LN were retrieved from 6,435 VABB. The histological diagnosis was ALH (atypical lobular hyperplasia) in 80 patients, LCIS (lobular carcinoma in situ) in 69 patients and PLCIS (pleomorphic lobular carcinoma in situ) in 12 patients. Seventy-six patients were operated on within 2 years after VABB and 85 were clinically and radiologically monitored. The mean follow-up was 5.2 years, and the prevalence of malignancy was evaluated in the group of 85 patients.


The clinico-pathological characteristics significantly favouring surgery were larger lesions, occurrence of a residual lesion following VABB and histological LCIS and PLCIS subtypes. The VABB underestimation rate as compared to surgery was 7.1 % for ALH, 12 % for LCIS and 50 % for PLCIS. Overall, 11 of the 148 patients included in this survival analysis developed an ipsilateral tumour.


Although obtained retrospectively in a relatively small series of patients, our data suggest that only patients with a diagnosis of PLCIS in VABB should be treated with surgery, whereas patients with ALH and LCIS could be monitored by clinical and radiological examinations.

Key Points

The treatment of ALH and LCIS in VABB is still debated

Some authors favour radical treatment and others a more conservative approach

Only patients with PLCIS in VABB should be treated by surgery


Breast cancer Lobular neoplasia Vacuum-assisted breast biopsy Non-palpable breast lesions Breast carcinoma in situ 



Atypical ductal hyperplasia


Atypical lobular hyperplasia


Breast imaging reporting and data system


Ductal carcinoma in situ


Disease-free survival


Invasive ductal cancer


Invasive lobular cancer


Lobular carcinoma in situ


Lobular neoplasia


Magnetic resonance imaging


Pleomorphic lobular carcinoma in situ


Terminal duct lobular unit




Vacuum-assisted breast biopsy


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Copyright information

© European Society of Radiology 2014

Authors and Affiliations

  • Meroni Stefano
    • 1
  • Bozzini Anna Carla
    • 1
  • Pruneri Giancarlo
    • 2
    • 3
  • Moscovici Oana Codrina
    • 4
  • Maisonneuve Patrick
    • 5
  • Menna Simona
    • 1
  • Penco Silvia
    • 1
  • Meneghetti Lorenza
    • 1
  • Renne Giuseppe
    • 3
  • Cassano Enrico
    • 1
  1. 1.Division of Breast RadiologyEuropean Institute of OncologyMilanItaly
  2. 2.University of Milan School of MedicineMilanItaly
  3. 3.Division of Pathology and Laboratory MedicineEuropean Institute of OncologyMilanItaly
  4. 4.Department of RadiologyIstituto Clinico HumanitasRozzanoItaly
  5. 5.Division of Epidemiology and BiostatisticsEuropean Institute of OncologyMilanItaly

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