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
Breast

Abstract

Objectives

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

Methods

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.

Results

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.

Conclusion

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

Keywords

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

Abbreviations

ADH

Atypical ductal hyperplasia

ALH

Atypical lobular hyperplasia

BI-RADS

Breast imaging reporting and data system

DCIS

Ductal carcinoma in situ

DFS

Disease-free survival

IDC

Invasive ductal cancer

ILC

Invasive lobular cancer

LCIS

Lobular carcinoma in situ

LN

Lobular neoplasia

MRI

Magnetic resonance imaging

PLCIS

Pleomorphic lobular carcinoma in situ

TDLU

Terminal duct lobular unit

US

Ultrasound

VABB

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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