{Reference Type}: Journal Article
{Title}: Factors Indicating Surgical Excision in Classical Type of Lobular Neoplasia of the Breast.
{Author}: Elfgen C;Tausch C;Rodewald AK;Güth U;Rageth C;Bjelic-Radisic V;Fleisch M;Kurtz C;Gonzalez Diaz J;Varga Z;
{Journal}: Breast Care (Basel)
{Volume}: 17
{Issue}: 2
{Year}: Apr 2022
{Factor}: 2.268
{DOI}: 10.1159/000516609
{Abstract}: <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.