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Non-classic LCIS Versus Classic LCIS Versus Atypical Hyperplasia: Should Management be the Same?

  • Breast Cancer Surgery (J. Tchou, Section Editor)
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Abstract

Purpose of Review

This review summarizes the literature from the last 5 years regarding atypical ductal hyperplasia (ADH), atypical lobular hyperplasia (ALH), classic lobular carcinoma in situ (C-LCIS), and non-classic LCIS (NC-LCIS).

Recent Findings

ADH, ALH, and C-LCIS are well-established markers of increased breast cancer risk. Recent studies suggest the possibility of observation for select cases of ADH diagnosed on core biopsy; however, guidelines support routine excision. In contrast, accumulating data support observation for ALH and C-LCIS on core biopsy with radiographic–pathologic concordance. Data on the natural history of pure NC-LCIS remain limited; however, when NC-LCIS is diagnosed on core biopsy, routine excision is warranted.

Summary

ALH and C-LCIS on core biopsy should be reviewed for concordance to determine the need for excision; independent of surgical excision, all warrant counseling regarding increased future breast cancer risk. Current guidelines support routine excision for ADH and NC-LCIS on core biopsy. The natural history of NC-LCIS remains poorly defined.

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Authors and Affiliations

  1. Department of Surgery, Brigham and Women’s Hospital, Boston, MA, USA

    Faina Nakhlis & Tari A. King

  2. Department of Pathology, Brigham and Women’s Hospital, Boston, MA, USA

    Beth T. Harrison

  3. Breast Oncology Program, Dana-Farber/Brigham and Women’s Cancer Center, Boston, MA, USA

    Faina Nakhlis, Beth T. Harrison & Tari A. King

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  1. Faina Nakhlis
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Nakhlis, F., Harrison, B.T. & King, T.A. Non-classic LCIS Versus Classic LCIS Versus Atypical Hyperplasia: Should Management be the Same?. Curr Surg Rep 6, 2 (2018). https://doi.org/10.1007/s40137-018-0201-1

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