Florid Lobular Carcinoma In Situ: Imaging Characteristics and Pathologic Upgrade Rates on Surgical Excision

IF 1.9 4区 医学 Q3 OBSTETRICS & GYNECOLOGY
Breast Journal Pub Date : 2025-03-30 DOI:10.1155/tbj/3580992
Anshumi Desai, Susan B. Kesmodel, Barbara Susnik, Neha Goel, Yara Feliciano, Carmen Gomez-Fernandez, Youley Tjendra
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引用次数: 0

Abstract

Background: Florid lobular carcinoma in situ is an uncommon lobular neoplasia variant that is frequently associated with invasive carcinoma. However, there remains a paucity of information to guide management. The authors aimed to study imaging features associated with pathologic upgrade rates for patients with florid lobular carcinoma in situ identified on core biopsy undergoing surgical excision.

Methods: Patients with florid lobular carcinoma in situ on core biopsy were selected from an institutional pathology database. Patients were excluded if pleomorphic lobular carcinoma in situ was also present on core biopsy. Clinical, radiologic, and pathologic features for each case were reviewed focusing on imaging features which led to core biopsy and those associated with pathologic upgrade on surgical excision.

Results: Eighteen cases of florid lobular carcinoma in situ underwent surgical excision. Upgrade rates on surgical excision were higher in cases with suspicious calcifications (8/11, 73%, p = 0.049) compared to those without (1/7, 14.3%) and in cases with larger breast lesions (p = 0.011). The overall upgrade rate was 50% (9/18), 89% (8/9) with invasive lobular carcinoma and 11% (1/9) with ductal carcinoma in situ. Of the 8 cases with upgrade to invasive lobular carcinoma, 7/8 (87.5%) were Stage I cancers and only 1/8 (12.5%) had macroscopic lymph node involvement and was upgraded to Stage II.

Conclusion: Florid lobular carcinoma in situ on core biopsy had an upgrade rate on surgical excision of 50% overall, with 89% of these cases upgraded to invasive lobular carcinoma. Pathologic upgrade was seen more frequently with suspicious calcifications and larger breast lesions. These findings can help guide surgical management of this uncommon lobular neoplasia variant including planning extent of excision and consideration for lymph node evaluation.

Abstract Image

红肿小叶原位癌:影像学特征和手术切除后的病理升级率
背景:花状小叶原位癌是一种罕见的小叶肿瘤变体,常与浸润性癌相关。然而,指导管理的信息仍然缺乏。作者的目的是研究在手术切除的核心活检中发现的红肿小叶原位癌患者与病理升级率相关的影像学特征。方法:从一个机构的病理数据库中选择核心活检的红小叶原位癌患者。如果在核心活检中也出现多形性小叶原位癌,则排除患者。我们回顾了每个病例的临床、放射学和病理特征,重点是导致核心活检的影像学特征和与手术切除的病理升级相关的影像学特征。结果:18例红叶原位癌均行手术切除。可疑钙化患者的手术升级率(8/ 11,73%,p = 0.049)高于无钙化患者(1/ 7,14.3%)和乳腺病变较大的患者(p = 0.011)。总体升级率为50%(9/18),浸润性小叶癌为89%(8/9),导管原位癌为11%(1/9)。在8例升级为浸润性小叶癌的病例中,7/8(87.5%)为I期肿瘤,只有1/8(12.5%)有肉眼淋巴结受累而升级为II期。结论:核心活检显示的红血球小叶原位癌在手术切除后的升级率为50%,其中89%的病例升级为浸润性小叶癌。病理升级多见于可疑的钙化和较大的乳腺病变。这些发现可以帮助指导这种罕见小叶瘤变的手术治疗,包括计划切除范围和考虑淋巴结评估。
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来源期刊
Breast Journal
Breast Journal 医学-妇产科学
CiteScore
4.00
自引率
0.00%
发文量
47
审稿时长
4-8 weeks
期刊介绍: The Breast Journal is the first comprehensive, multidisciplinary source devoted exclusively to all facets of research, diagnosis, and treatment of breast disease. The Breast Journal encompasses the latest news and technologies from the many medical specialties concerned with breast disease care in order to address the disease within the context of an integrated breast health care. This editorial philosophy recognizes the special social, sexual, and psychological considerations that distinguish cancer, and breast cancer in particular, from other serious diseases. Topics specifically within the scope of The Breast Journal include: Risk Factors Prevention Early Detection Diagnosis and Therapy Psychological Issues Quality of Life Biology of Breast Cancer.
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