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

作者：Stefano Meroni^*; Carla Bozzini Anna; Giancarlo Pruneri; Codrina Moscovici Oana; Patrick Maisonneuve; Simona Menna; Silvia Penco; Lorenza Meneghetti; Giuseppe Renne; Enrico Cassano

来源：European Radiology, 2014, 24(7): 1651-1658.

DOI：10.1007/s00330-014-3132-y

• Breast cancer
• Lobular neoplasia
• Vacuum-assisted breast biopsy
• Non-palpable breast lesions
• Breast carcinoma in situ

To evaluate the underestimation rate and clinical relevance of lobular neoplasia in vacuum-assisted breast biopsy (VABB).
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.
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.
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.
aEuro cent The treatment of ALH and LCIS in VABB is still debated
aEuro cent Some authors favour radical treatment and others a more conservative approach
aEuro cent Only patients with PLCIS in VABB should be treated by surgery.

• 出版日期2014-7