Factors Indicating Surgical Excision in Classical Type of Lobular Neoplasia of the Breast

IF 2 4区医学 Q2 OBSTETRICS & GYNECOLOGY

Breast Care Pub Date : 2021-07-07 DOI:10.1159/000516609

C. Elfgen, C. Tausch, A. Rodewald, U. Güth, C. Rageth, V. Bjelic-Radisic, M. Fleisch, C. Kurtz, J. Gonzalez Diaz, Z. Varga

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引用次数: 5

Abstract

Purpose: 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. Methods: 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. Results: 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. Conclusions: 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.

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典型乳腺小叶性肿瘤手术切除的因素分析

目的:经典小叶瘤变(LN)包括非典型小叶增生和乳腺经典小叶原位癌，是一种不确定恶性潜能的病变，已成为几项研究的主题，结果相互矛盾。我们研究的目的是阐明经典LN的结局相关因素和治疗方案。方法:我们对来自苏黎世乳腺中心的160例LN患者进行了术前活检标本的病理再评估和回顾性临床和放射学资料分析。65例患者行开放手术，79例患者行真空辅助活检(VAB)， 16例患者行乳房核心穿刺活检(CNB)后监测。结果:影像学/组织学不一致时，导管原位癌/浸润性癌的升级率最高(40%)。活检标本中病灶数≥3个，连续手术标本升级率提高(p = 0.01)。经典LN与组织学微钙化的相关性与缩短无病生存期相关(p < 0.01)，而其他因素对随访无影响。结论:在大多数病例中，LN CNB后的监测或后续VAB是足够的。需要仔细考虑个体放射学和组织学因素，以确定高风险升级为恶性肿瘤的患者。在这种情况下，需要手术切除。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Breast Care 医学-妇产科学

CiteScore

4.40

自引率

4.80%

发文量

审稿时长

6-12 weeks

期刊介绍： ''Breast Care'' is a peer-reviewed scientific journal that covers all aspects of breast biology. Due to its interdisciplinary perspective, it encompasses articles on basic research, prevention, diagnosis, and treatment of malignant diseases of the breast. In addition to presenting current developments in clinical research, the scope of clinical practice is broadened by including articles on relevant legal, financial and economic issues.