Assessment of association of lobular neoplasia in tru-cut needle biopsy specimens with a low risk of ductal carcinoma on subsequent excision

ABSTRACT

To determine the rate of duct carcinoma in situ and invasive carcinoma in subsequent excisions for lobular neoplasia alone on core needle biopsy. It was an analytical study. Damanhour National medical Institute, Egypt from July 2004 to August 2006. Result of 117 cases of breast core needle biopsy diagnosed as lobular neoplasia were reviewed over a period of 2 yrs. Additional lesions were also identified including the presence of ductal carcinoma in situ [DCIS] or invasive carcinoma and atypical ductal hyperplasia [ADH] Tissue follow-up was obtained from hospital records. Statistical analysis was performed using a 2-tailed fisher exact test. Lobular carcinoma was diagnosed by core needle biopsy in 117 women; in 25 [21.6%], invasive carcinoma [IC] or ductal carcinoma in situ [DCIS] was diagnosed concurrently. Two patients had previous diagnoses of IC or DCIS, and 4 [3.6%] had a concurrent diagnosis of contra-lateral IC or DCIS. Of 92 patients without a concurrent diagnosis of IC or DCIS, subsequent tissue diagnoses were available for 39 eases [42.6%]. Of 15 cases of lobular neoplasia and atypical ductal hyperplasia on the biopsy, 1 had IC and 3 had DCIS on the excision. Of the women with lobular neoplasia and a mucoeele-like lesion on the biopsy, none had IC or DCIS on excision. Of 23 with lobular neoplasia alone on the biopsy, 2 had IC on excision. As lobular carcinoma is associated with a high overall rate of IC and DCTS [30%], women in whom biopsy sites are excised are still at risk for subsequent DCIS and IC