%0 Journal Article
%T Factors Indicating Surgical Excision in Classical Type of Lobular Neoplasia of the Breast.
%A Elfgen C
%A Tausch C
%A Rodewald AK
%A Güth U
%A Rageth C
%A Bjelic-Radisic V
%A Fleisch M
%A Kurtz C
%A Gonzalez Diaz J
%A Varga Z
%J Breast Care (Basel)
%V 17
%N 2
%D Apr 2022
%M 35702498
%F 2.268
%R 10.1159/000516609
%X <B>UNASSIGNED: </B>Classical type of lobular neoplasia (LN) encompassing both atypical lobular hyperplasia and classical lobular carcinoma in situ of the breast is a lesion with uncertain malignant potential and has been the topic of several studies with conflicting outcome results. The aim of our study was to clarify outcome-relevant factors and treatment options of classical LN.<BR><B>UNASSIGNED: </B>We performed a pathological re-evaluation of the preoperative biopsy specimens and a retrospective clinical and radiological data analysis of 160 patients with LN from the Breast Center Zurich. Open surgery was performed in 65 patients, vacuum-assisted biopsy (VAB) in 79 patients, and surveillance after breast core needle biopsy (CNB) in 16 patients.<BR><B>UNASSIGNED: </B>The upgrade rate into ductal carcinoma in situ/invasive cancer was the highest in case of imaging/histology discordance (40%). If the number of foci in the biopsy specimen was ≥3, the upgrade rate in the consecutive surgical specimens was increased (p = 0.01). The association of classical LN with histological microcalcification correlated with shortened disease-free survival (p < 0.01), whereas other factors showed no impact on follow-up.<BR><B>UNASSIGNED: </B>Surveillance or subsequent VAB after CNB of LN is sufficient in most cases. Careful consideration of individual radiological and histological factors is required to identify patients with a high risk of upgrade into malignancy. In those cases, surgical excision is indicated.