Abstract
Lobular neoplasia (LN) refers to the spectrum of benign epithelial proliferation including atypical lobular hyperplasia (ALH) and lobular carcinoma in situ (LCIS) (1). It is usually an incidental finding noted at the time of needle or excisional biopsy and lacks distinctive features on imaging or physical exam.
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References
Haagensen CD, Lane N, Lattes R, et al. Lobular neoplasia (so-called lobular carcinoma in situ) of the breast. Cancer. 1978;42:737–69.
Andersen JA. Lobular carcinoma in situ of the breast. An approach to rational treatment. Cancer. 1977;39:2597–602.
Bauer TL, Pandelidis SM, Rhoads Jr JE. Five-year survival of 100 women with carcinoma of the breast diagnosed by screening mammography and needle-localization biopsy. J Am Coll Surg. 1994;178:427–30.
Page DL, Dupont WD, Rogers LW, Rados MS. Atypical hyperplastic lesions of the female breast. A long-term follow-up study. Cancer. 1985;55(11):2698–708.
Oppong BA, King TA. Recommendations for women with lobular carcinoma in situ (LCIS). Oncology (Williston Park). 2011;25(11):1051–6, 1058.
Urban JA. Bilaterality of cancer of the breast. Biopsy of the opposite breast. Cancer. 1967;20:1867–70.
Rosen PP, Senie R, Schottenfeld D, et al. Noninvasive breast carcinoma: frequency of unsuspected invasion and implications for treatment. Ann Surg. 1979;189(3):377–82.
Simpson PT, Reis-Filho JS, Lakhani S. Lobular carcinoma in situ: biology and pathology, diseases of the breast. Philadelphia: Lippincott Williams and Wilkins; 2004.
Page DL, Schuyler PA, Dupont WD, et al. Atypical lobular hyperplasia as a unilateral predictor of breast cancer risk: a retrospective cohort study. Lancet. 2003;361:125–9.
Ottesen GL, Graversen HP, Blichert-Toft M, et al. Lobular carcinoma in situ of the female breast. Short-term results of a prospective nationwide study. The Danish Breast Cancer Cooperative Group. Am J Surg Pathol. 1993;17:14–21.
Marshall LM, Hunter DJ, Connolly JL, et al. Risk of breast cancer associated with atypical hyperplasia of lobular and ductal types. Cancer Epidemiol Biomarkers Prev. 1997;6:297–301.
Hutter RV, Foote Jr FW. Lobular carcinoma in situ. Long term follow-up. Cancer. 1969;24(5):1081–5.
Chuba PJ, Hamre MR, Yap J, et al. Bilateral risk for subsequent breast cancer after lobular carcinoma-in-situ: analysis of surveillance, epidemiology, and end results data. J Clin Oncol. 2005;23:5534–41.
Rosen PP, Kosloff C, Lieberman PH, et al. Lobular carcinoma in situ of the breast. Detailed analysis of 99 patients with average follow-up of 24 years. Am J Surg Pathol. 1978;2:225–51.
Li CI, Malone KE, Saltzman BS, et al. Risk of invasive breast carcinoma among women diagnosed with ductal carcinoma in situ and lobular carcinoma in situ, 1988–2001. Cancer. 2006;106:2104–12.
Haagensen CD. Diseases of the breast. 2nd ed. Philadelphia: WB Saunders; 1971. p. 503–27.
Wheeler JE, Enterline HT, Roseman JM, et al. Lobular carcinoma in situ of the breast. Long-term follow up. Cancer. 1974;34(3):554–63.
Page DL, Kidd Jr TE, Dupont WD, et al. Lobular neoplasia of the breast: higher risk for subsequent invasive cancer predicted by more extensive disease. Hum Pathol. 1991;22:1232–9.
Hwang H, Barke LD, Mendelson EB, Susnik B. Atypical lobular hyperplasia and classic lobular carcinoma in situ in core biopsy specimens: routine excision is not necessary. Mod Pathol. 2008;21(10):1208–16.
Liberman L, Sama M, Susnik B, et al. Lobular carcinoma in situ at percutaneous breast biopsy: surgical biopsy findings. AJR Am J Roentgenol. 1999;173:291–9.
Berg WA, Mrose HE, Ioffe OB. Atypical lobular hyperplasia or lobular carcinoma in situ at core-needle breast biopsy. Radiology. 2001;218:503–9.
Hussain M, Cunnick GH. Management of lobular carcinoma in-situ and atypical lobular hyperplasia of the breast—a review. Eur J Surg Oncol. 2011;37:279–89.
Philpotts LE, Shaheen NA, Jain KS, et al. Uncommon high-risk lesions of the breast diagnosed at stereotactic core-needle biopsy: clinical importance. Radiology. 2000;216:831–7.
Li CI, Anderson BO, Daling JR, Moe RE. Changing incidence of lobular carcinoma in situ of the breast. Breast Cancer Res Treat. 2002;75(3):259–68.
Foote FW, Stewart SF. Lobular carcinoma in situ: a rare form of mammary cancer. Am J Pathol. 1941;17(4):491–96.
Page DL, Anderson TJ, Rogers LW. Carcinoma in situ (CIS). Diagnostic histopathology of the breast. New York: Churchill Livingstone; 1987.
Simpson PT, Gale T, Fulford LG, et al. The diagnosis and management of pre-invasive breast disease: pathology of atypical lobular hyperplasia and lobular carcinoma in situ. Breast Cancer Res. 2003;5:258–62.
Shah-Khan MG, Geiger XJ, Reynolds C, et al. Long-term follow-up of lobular neoplasia (atypical lobular hyperplasia/lobular carcinoma in situ) diagnosed on core needle biopsy. Ann Surg Oncol. 2012;19(10):3131–8.
Sneige N, Wang J, Baker BA, et al. Clinical, histopathologic, and biologic features of pleomorphic lobular (ductal-lobular) carcinoma in situ of the breast: a report of 24 cases. Mod Pathol. 2002;15:1044–50.
Jacobs TW, Pliss N, Kouria G, et al. Carcinomas in situ of the breast with indeterminate features: role of E-cadherin staining in categorization. Am J Surg Pathol. 2001;25:229–36.
Rosai J. Borderline epithelial lesions of the breast. Am J Surg Pathol. 1991;15(3):209–21.
Tavassoli FA. Pathology of the breast. 2nd ed. Norwalk: Appleton and Lange; 1999.
Esserman LJ, Thompson Jr IM, Reid B. Overdiagnosis and overtreatment in cancer: an opportunity for improvement. JAMA. 2013;310(8):797–8.
Referenced with permission from The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Breast Cancer V.1.2013. © National Comprehensive Cancer Network, Inc 2013. All rights reserved. Accessed January 1, 2013. To view the most recent and complete version of the guideline, go online to www.nccn.org. National Comprehensive Cancer Network®, NCCN®, NCCN GUIDELINES®, and all other NCCN Content are trademarks owned by the National Comprehensive Cancer Network, Inc.
Yeh IT, Dimitrov D, Otto P, et al. Pathologic review of atypical hyperplasia identified by image-guided breast needle core biopsy. Correlation with excision specimen. Arch Pathol Lab Med. 2003;127:49–54.
Foster MC, Helvie MA, Gregory NE, et al. Lobular carcinoma in situ or atypical lobular hyperplasia at core-needle biopsy: is excisional biopsy necessary? Radiology. 2004;231:813–9.
Elsheikh TM, Silverman JF. Follow-up surgical excision is indicated when breast core needle biopsies show atypical lobular hyperplasia or lobular carcinoma in situ: a correlative study of 33 patients with review of the literature. Am J Surg Pathol. 2005;29(4):534–43.
Margenthaler JA, Duke D, Monsees BS, et al. Correlation between core biopsy and excisional biopsy in breast high-risk lesions. Am J Surg. 2006;192:534–7.
Brem RF, Lechner MC, Jackman RJ, et al. Lobular neoplasia at percutaneous breast biopsy: variables associated with carcinoma at surgical excision. AJR Am J Roentgenol. 2008;190:637–41.
Cangiarella J, Guth A, Axelrod D, et al. Is surgical excision necessary for the management of atypical lobular hyperplasia and lobular carcinoma in situ diagnosed on core needle biopsy? A report of 38 cases and review of the literature. Arch Pathol Lab Med. 2008;132:979–83.
Londero V, Zuiani C, Linda A, et al. Lobular neoplasia: core needle breast biopsy underestimation of malignancy in relation to radiologic and pathologic features. Breast. 2008;17:623–30.
Rendi MH, Dintzis SM, Lehman CD, et al. Lobular in-situ neoplasia on breast core needle biopsy: imaging indication and pathologic extent can identify which patients require excisional biopsy. Ann Surg Oncol. 2012;19:914–21.
Murray MP, Luedtke C, Liberman L, et al. Classic lobular carcinoma in situ and atypical lobular hyperplasia at percutaneous breast core biopsy: outcomes of prospective excision. Cancer. 2013;119(5):1073–9.
Nagi CS, O’Donnell JE, Tismenetsky M, et al. Lobular neoplasia on core needle biopsy does not require excision. Cancer. 2008;112:2152–8.
Esserman LE, Lamea L, Tanev S, et al. Should the extent of lobular neoplasia on core biopsy influence the decision for excision? Breast J. 2007;13:55–61.
Degnim AC, King TA. Surgical management of high-risk breast lesions. Surg Clin North Am. 2013;93(2):329–40.
Fisher B, Costantino JP, Wickerham DL, et al. Tamoxifen for the prevention of breast cancer: current status of the National Surgical Adjuvant Breast and Bowel Project P-1 study. J Natl Cancer Inst. 2005;97:1652.
Fisher B, Costantino JP, Wickerham DL, et al. Tamoxifen for the prevention of breast cancer: report of the National Surgical Adjuvant Breast and Bowel Project P-1 study. J Natl Cancer Inst. 1998;90:1371–88.
Cummings SR, Eckert S, Krueger KA, et al. The effect of raloxifene on risk of breast cancer in postmenopausal women: results from the MORE randomized trial. Multiple outcomes of raloxifene evaluation. JAMA. 1999;281:2189–97.
Vogel VG, Costantino JP, Wickerham DL, et al. Effects of tamoxifen vs raloxifene on the risk of developing invasive breast cancer and other disease outcomes: the NSABP Study of Tamoxifen and Raloxifene (STAR) P-2 trial. JAMA. 2006;295:2727–41.
Goss PE, Ingle JN, Ales-Martinez J, et al. Exemestane for breast-cancer prevention in postmenopausal women. N Engl J Med. 2011;364:2381–91.
Tchou J, Hou N, Rademaker A, et al. Acceptance of tamoxifen chemoprevention by physicians and women at risk. Cancer. 2004;100(9):1800–6.
Port ER, Montgomery LL, Heerdt AS, Borgen PI. Patient reluctance toward tamoxifen use for breast cancer primary prevention. Ann Surg Oncol. 2001;8(7):580–5.
Oskar S, Muhsen S, Sung J, et al. Chemoprevention among women with lobular carcinoma in situ. Ann Surg Oncol. 2011;18:S59.
Hartmann LC, Schaid DJ, Woods JE, et al. Efficacy of bilateral prophylactic mastectomy in women with a family history of breast cancer. N Engl J Med. 1999;340:77–84.
Muhsen S, Junqueira MJ, Park A, et al. Patient characteristics associated with the decision to undergo bilateral prophylactic mastectomy for lobular carcinoma in situ. J Clin Oncol. 2011;29 (S27, A148).
Katipamula R, Degnim AC, Hoskin T, et al. Trends in mastectomy rates at the Mayo Clinic Rochester: effect of surgical year and preoperative magnetic resonance imaging. J Clin Oncol. 2009;27(25):4082–8.
Yao K, Stewart AK, Winchester DJ, Winchester DP. Trends in contralateral prophylactic mastectomy for unilateral cancer: a report from the National Cancer Data Base, 1998–2007. Ann Surg Oncol. 2010;17(10):2554–62.
Chung A, Huynh K, Lawrence C, Sim MS, Giuliano A. Comparison of patient characteristics and outcomes of contralateral prophylactic mastectomy and unilateral total mastectomy in breast cancer patients. Ann Surg Oncol. 2012;19(8):2600–6.
Arrington AK, Jarosek SL, Virnig BA, Habermann EB, Tuttle TM. Patient and surgeon characteristics associated with increased use of contralateral prophylactic mastectomy in patients with breast cancer. Ann Surg Oncol. 2009;16(10):2697–704.
Lostumbo L, Carbine NE, Wallace J. Prophylactic mastectomy for the prevention of breast cancer. Cochrane Database Syst Rev. 2010;11:CD002748.
Bodian CA, Perzin KH, Lattes R. Lobular neoplasia. Long term risk of breast cancer and relation to other factors. Cancer. 1996;78(5):1024–34.
Fisher ER, Land SR, Fisher B, et al. Pathologic findings from the National Surgical Adjuvant Breast and Bowel Project: twelve-year observations concerning lobular carcinoma in situ. Cancer. 2004;100:238–44.
Pankratz VS, Hartmann LC, Degnim AC, et al. Assessment of the accuracy of the Gail model in women with atypical hyperplasia. J Clin Oncol. 2008;26(33):5374–9.
Ottesen GL, Graversen HP, Blichert-Toft M, et al. Carcinoma in situ of the female breast. 10 year follow-up results of a prospective nationwide study. Breast Cancer Res Treat. 2000;62(3):197–210.
De Leeuw WJ, Berx G, Vos CB, et al. Simultaneous loss of E-cadherin and catenins in invasive lobular breast cancer and lobular carcinoma in situ. J Pathol. 1997;183:404–11.
Hwang ES, Nyante SJ, Yi Chen Y, et al. Clonality of lobular carcinoma in situ and synchronous invasive lobular carcinoma. Cancer. 2004;100:2562–72.
Lakhani SR, Collins N, Sloane JP, Stratton MR. Loss of heterozygosity in lobular carcinoma in situ of the breast. Clin Mol Pathol. 1995;48:M74–8.
Bentz JS, Yassa N, Clayton F. Pleomorphic lobular carcinoma of the breast: clinicopathologic features of 12 cases. Mod Pathol. 1998;11(9):814–22.
Downs-Kelly E, Bell D, Perkins GH, et al. Clinical implications of margin involvement by pleomorphic lobular carcinoma in situ. Arch Pathol Lab Med. 2011;135(6):737–43.
Ciocca RM, Li T, Freedman GM, Morrow M. Presence of lobular carcinoma in situ does not increase local recurrence in patients treated with breast-conserving therapy. Ann Surg Oncol. 2008;15(8):2263–71.
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.
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 surgery. Int J Radiat Oncol Biol Phys. 2006;66(2):365–71.
Li S, Liu J, Yang Y, et al. Impact of atypical hyperplasia at margins of breast-conserving surgery on the recurrence of breast cancer. J Cancer Res Clin Oncol. 2014;140(4):599–605.
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Shah-Khan, M.G., Jakub, J.W. (2015). Lobular Neoplasia: Atypical Lobular Hyperplasia and Lobular Carcinoma In Situ. In: Riker, A. (eds) Breast Disease. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-1145-5_10
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