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European Radiology
Published in: European Radiology 7/2014

01-07-2014 | Breast

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

Authors: Meroni Stefano, Bozzini Anna Carla, Pruneri Giancarlo, Moscovici Oana Codrina, Maisonneuve Patrick, Menna Simona, Penco Silvia, Meneghetti Lorenza, Renne Giuseppe, Cassano Enrico

Published in: European Radiology | Issue 7/2014

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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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Metadata
Title
Underestimation rate of lobular intraepithelial neoplasia in vacuum-assisted breast biopsy
Authors
Meroni Stefano
Bozzini Anna Carla
Pruneri Giancarlo
Moscovici Oana Codrina
Maisonneuve Patrick
Menna Simona
Penco Silvia
Meneghetti Lorenza
Renne Giuseppe
Cassano Enrico
Publication date
01-07-2014
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 7/2014
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-014-3132-y

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