The Diagnosis of Pleomorphic Lobular Carcinoma In Situ Warrants Complete Excision with Negative Margins
- 145 Downloads
Pleomorphic lobular carcinoma in situ (PLCIS) is a recently described variant of lobular carcinoma in situ. Although classic lobular carcinoma in situ (LCIS) is seen as a risk factor and non-obligate precursor for the development of invasive breast cancer, PLCIS is considered an even greater high-risk lesion. When patients are diagnosed with PLCIS on core biopsy, the recommendation is to perform an excisional biopsy of the affected area. Re-excision is not commonly recommended for patients with classic LCIS at or near a margin after breast conserving therapy, whereas excision with negative margins is recommended for patients with PLCIS. This review gives an overview of the biologic rationale for complete excision with negative margins for patients diagnosed with PLCIS, reviews historical data and clinical studies relevant to patients with PLCIS, and provides molecular rationale that supports treating patients with PLCIS more aggressively than patients with classic LCIS, and similar to intermediate-grade ductal carcinoma in situ (DCIS).
KeywordsPleomorphic lobular carcinoma in situ Margin assessment Breast conserving therapy
No conflicts of interest relevant to this article were reported.
Papers of particular interest, published recently, have been highlighted as: • Of importance
- 3.Georgian-Smith D, Lawton TJ. Calcifications of lobular carcinoma in situ of the breast: radiologic-pathologic correlation. Virchows Arch. 2001;176:1255–9.Google Scholar
- 16.• Apple SK, Matin M, Olsen EP, Moatamed NA. Significance of lobular intraepithelial neoplasia at margins of breast conservation specimens: a report of 38 cases and literature review. Diagn Pathol. 2010;5:54. Review. This article discusses the significance of lobular carcinoma in situ at margins of resection and provides literature review.PubMedCrossRefGoogle Scholar
- 19.Jolly S, Kestin LL, Goldstein NS, Vicini FA. The impact of lobular carcinoma in situ in association with invasive breast cancer on the rate of local recurrence in patients with early-stage breast cancer treated with breast-conserving therapy. Int J Radiat Oncol Biol Phys. 2006;66:365–71.PubMedCrossRefGoogle Scholar
- 24.World Health Organization Classification of Tumors. Pathology and Genetics of Tumours of Breast and Female Genital Organs. Edited by Tavassoli F, Devilee P. Lyon, France: IARC Press; 2003:37–38.Google Scholar