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Lobular neoplasia found on breast biopsy: marker of increased risk of malignancy or direct pre-cancerous lesion?

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Author(s): Bartłomiej Szynglarewicz | Rafał Matkowski | Agnieszka Hałoń | Piotr Kasprzak | Józef Forgacz | Iwona Gisterek | Jan Kornafel

Journal: Folia Histochemica et Cytobiologica
ISSN 0239-8508

Volume: 49;
Issue: 3;
Start page: 417;
Date: 2011;
Original page

Keywords: breast cancer | breast biopsy | lobular carcinoma in situ | atypical lobular hyperplasia | lobular neoplasia

ABSTRACT
The aim of this study was to compare the imaging symptoms and microscopic findings in females with lobularneoplasia (LN) found on biopsy. 1,478 women who underwent primary open biopsy or surgical excision after percutaneousbiopsy were reviewed. In 24 of them (1.6%), LN was found. In four patients, excisional biopsy with hook-wirelocalization was done primarily due to the radial scar. In 20 females, surgical excision of BIRADS 4 lesion was performedbecause of the presence of LN in specimens from the vacuum-assisted or core-needle percutaneous biopsy.Postoperative pathologic findings were compared to the radiological symptoms. In 13 women, LN did not produceany radiological symptoms and was an additional histologic finding existing near the other lesion: fibroadenoma andradial scar. In none of these lesions was an invasive cancer noticed. In one single patient, ductal carcinoma in situ wasobserved in the other segment of the breast. Invasive ductal cancer developed in the contralateral breast in one patient.In 11 patients, LN was diagnosed due to radiological symptoms produced by itself. In this group, the invasive lobularcancer was found in seven lesions (64%). Our finding suggests that LN producing suspicious radiological symptomscan be a different biologic type of this lesion when compared asymptomatic LN diagnosed which is usually found onbiopsy as additional microscopic pathology. Symptomatic LN is probably associated with a higher potential of malignanttransformation. (Folia Histochemica et Cytobiologica 2011; Vol. 49, No. 3, pp. 417–424)
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