Abstract：
OBJECTIVE: To determine the risk of breast cancer due to lobular carcinoma in situ (LCIS).
METHODS: This retrospective IRB-approved study identified cases of LCIS after percutaneous breast biopsy from 7/2005 to 7/2022. Excluded were cases with less than 2 years of imaging surveillance or a concurrent ipsilateral breast cancer diagnosis within 6 months of the LCIS diagnosis. Final outcomes of cancer versus no cancer were determined by pathology at surgical excision or the absence of cancer on imaging surveillance.
RESULTS: A total of 116 LCIS lesions were identified. The primary imaging findings targeted for percutaneous biopsy included calcifications (50.0%, 58/116), MR enhancing lesions (25.0%, 29/116), noncalcified mammographic architectural distortions (10.3%, 12/116), or masses (14.7%, 17/116). Surgical excision was performed in 49.1% (57/116) and imaging surveillance was performed in 50.9% (59/116) of LCIS cases. There were 22 cancers of which 11 cancers were discovered at immediate excision [19.3% (11/57) immediate upgrade] and 11 cancers developed later while on imaging surveillance [18.6% (11/59) delayed risk for cancer]. Among all 22 cancers, 63.6% (14/22) occurred at the site of LCIS (11 at immediate excision and 3 at surveillance) and 36.4% (8/22) occurred at a location away from the site of LCIS (6 in a different quadrant and 2 in the contralateral breast).
CONCLUSIONS: LCIS has both an immediate risk (19.3%) and a delayed risk (18.6%) for cancer with 90.9% occurring in the ipsilateral breast (63.6% at and 27.3% away from the site of LCIS) and 9.1% occurring in the contralateral breast.
METHODS: This retrospective IRB-approved study identified cases of LCIS after percutaneous breast biopsy from 7/2005 to 7/2022. Excluded were cases with less than 2 years of imaging surveillance or a concurrent ipsilateral breast cancer diagnosis within 6 months of the LCIS diagnosis. Final outcomes of cancer versus no cancer were determined by pathology at surgical excision or the absence of cancer on imaging surveillance.
RESULTS: A total of 116 LCIS lesions were identified. The primary imaging findings targeted for percutaneous biopsy included calcifications (50.0%, 58/116), MR enhancing lesions (25.0%, 29/116), noncalcified mammographic architectural distortions (10.3%, 12/116), or masses (14.7%, 17/116). Surgical excision was performed in 49.1% (57/116) and imaging surveillance was performed in 50.9% (59/116) of LCIS cases. There were 22 cancers of which 11 cancers were discovered at immediate excision [19.3% (11/57) immediate upgrade] and 11 cancers developed later while on imaging surveillance [18.6% (11/59) delayed risk for cancer]. Among all 22 cancers, 63.6% (14/22) occurred at the site of LCIS (11 at immediate excision and 3 at surveillance) and 36.4% (8/22) occurred at a location away from the site of LCIS (6 in a different quadrant and 2 in the contralateral breast).
CONCLUSIONS: LCIS has both an immediate risk (19.3%) and a delayed risk (18.6%) for cancer with 90.9% occurring in the ipsilateral breast (63.6% at and 27.3% away from the site of LCIS) and 9.1% occurring in the contralateral breast.
摘要：
目的：确定小叶原位癌（LCIS）导致乳腺癌的风险。
方法：这项回顾性IRB批准的研究确定了2005年7月7日至2022年7月7日经皮乳腺活检后的LCIS病例。排除了影像学监测少于2年或在LCIS诊断后6个月内同时诊断为同侧乳腺癌的病例。通过手术切除时的病理学或影像学监测中不存在癌症来确定癌症与非癌症的最终结果。
结果：共发现116个LCIS病灶。经皮穿刺活检的主要影像学发现包括钙化（50.0%，58/116)，MR增强病灶（25.0%，29/116），非钙化乳房X线摄影建筑扭曲(10.3%，12/116),或质量(14.7%，17/116)。手术切除占49.1%(57/116)，影像学监测占50.9%(59/116)。有22种癌症，其中11种癌症是在立即切除时发现的[19.3％（11/57）立即升级]，11种癌症在影像学监测后发展[18.6％（11/59）延迟癌症风险]。在所有22种癌症中，63.6％（14/22）发生在LCIS部位（立即切除11例，监视3例），36.4％（8/22）发生在远离LCIS部位的位置（不同象限6例，对侧乳房2例）。
结论：LCIS具有癌症的即时风险（19.3％）和延迟风险（18.6％），其中90.9％发生在同侧乳腺（63.6％和27.3％远离LCIS），9.1％发生在对侧乳腺。
方法：这项回顾性IRB批准的研究确定了2005年7月7日至2022年7月7日经皮乳腺活检后的LCIS病例。排除了影像学监测少于2年或在LCIS诊断后6个月内同时诊断为同侧乳腺癌的病例。通过手术切除时的病理学或影像学监测中不存在癌症来确定癌症与非癌症的最终结果。
结果：共发现116个LCIS病灶。经皮穿刺活检的主要影像学发现包括钙化（50.0%，58/116)，MR增强病灶（25.0%，29/116），非钙化乳房X线摄影建筑扭曲(10.3%，12/116),或质量(14.7%，17/116)。手术切除占49.1%(57/116)，影像学监测占50.9%(59/116)。有22种癌症，其中11种癌症是在立即切除时发现的[19.3％（11/57）立即升级]，11种癌症在影像学监测后发展[18.6％（11/59）延迟癌症风险]。在所有22种癌症中，63.6％（14/22）发生在LCIS部位（立即切除11例，监视3例），36.4％（8/22）发生在远离LCIS部位的位置（不同象限6例，对侧乳房2例）。
结论：LCIS具有癌症的即时风险（19.3％）和延迟风险（18.6％），其中90.9％发生在同侧乳腺（63.6％和27.3％远离LCIS），9.1％发生在对侧乳腺。
