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

  • Breast
  • Published:
European Radiology Aims and scope Submit manuscript

An Erratum to this article was published on 28 May 2014

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

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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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Acknowledgments

The scientific guarantor of this publication is Enrico Cassano. The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. Patrick Maisonneuve kindly provided statistical advice for this manuscript. Institutional review board approval was obtained. Written informed consent was obtained from all subjects (patients) in this study. Methodology: retrospective, observational, performed at one institution.

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Authors and Affiliations

  1. Division of Breast Radiology, European Institute of Oncology, Via G. Ripamonti, 435, 20141, Milan, Italy

    Meroni Stefano, Bozzini Anna Carla, Menna Simona, Penco Silvia, Meneghetti Lorenza & Cassano Enrico

  2. University of Milan School of Medicine, Milan, Italy

    Pruneri Giancarlo

  3. Division of Pathology and Laboratory Medicine, European Institute of Oncology, Via G. Ripamonti, 435, 20141, Milan, Italy

    Pruneri Giancarlo & Renne Giuseppe

  4. Department of Radiology, Istituto Clinico Humanitas, Via A. Manzoni, 56, 20089, Rozzano, Milan, Italy

    Moscovici Oana Codrina

  5. Division of Epidemiology and Biostatistics, European Institute of Oncology, Via G. Ripamonti, 435, 20141, Milan, Italy

    Maisonneuve Patrick

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  1. Meroni Stefano
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  2. Bozzini Anna Carla
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  10. Cassano Enrico
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Correspondence to Meroni Stefano.

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Stefano, M., Carla, B.A., Giancarlo, P. et al. Underestimation rate of lobular intraepithelial neoplasia in vacuum-assisted breast biopsy. Eur Radiol 24, 1651–1658 (2014). https://doi.org/10.1007/s00330-014-3132-y

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  • DOI: https://doi.org/10.1007/s00330-014-3132-y

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