Non-classic LCIS Versus Classic LCIS Versus Atypical Hyperplasia: Should Management be the Same?
AbstractPurpose of ReviewThis review summarizes the literature from the last 5 years regarding atypical ductal hyperplasia (ADH), atypical lobular hyperplasia (ALH), classic lobular carcinoma in situ (C-LCIS), and non-classic LCIS (NC-LCIS).Recent FindingsADH, ALH, and C-LCIS are well-established markers of increased breast cancer risk. Recent studies suggest the possibility of observation for select cases of ADH diagnosed on core biopsy; however, guidelines support routine excision. In contrast, accumulating data support observation for ALH and C-LCIS on core biopsy with radiographic –pathologic concordance. Data on the natural history of pure NC-LCIS remain limited; however, when NC-LCIS is diagnosed on core biopsy, routine excision is warranted.SummaryALH and C-LCIS on core biopsy should be reviewed for concordance to determine the need for excision; independent of surgical excision, all warrant counseling regarding increased future breast cancer risk. Current guidelines support routine excision for ADH and NC-LCIS on core biopsy. The natural history of NC-LCIS remains poorly defined.
CONCLUSION: We conclude that the upgrade rate for high-risk lesions at MRI-VAB at surgical excision is low. Surgical excision is warranted for ADH and combined ALH-LCIS lesions. For other lesions, a multidisciplinary approach to decide on personalized management may be appropriate. Advancesin knowledge: Surgical excision is warranted for ADH lesions and combined ALH-LCIS lesions identified at breast MRI-VAB. A multidisciplinary approach to patient management of other high-risk lesions may be appropriate. PMID: 29947265 [PubMed - as supplied by publisher]
Validation of the IBIS breast cancer risk evaluator for women with lobular carcinoma in-situ, Published online: 21 June 2018; doi:10.1038/s41416-018-0120-zValidation of the IBIS breast cancer risk evaluator for women with lobular carcinoma in-situ
Conclusions: Oncoplastic breast reductions allow wide resections with free margins and can be used for large cancers as an alternative to mastectomy.
In the eighth edition of the American Joint Committee on Cancer staging system for breast cancer, the definitions for T (tumor), N (nodes), and M (metastases) remain substantially unchanged but with clarifications for certain categories that may have been problematic for pathologists and clinicians. The principal change is the decision to exclude lobular carcinoma in situ from T classification. In contrast, there is a major change in how stage is determined by introducing a new clinical prognostic stage and a new pathological prognostic stage. These prognostic stages incorporate information about grade, estrogen receptor e...
Conclusions High-risk women with greater than minimal BPE at screening MRI have increased risk of future breast cancer.
CONCLUSION Our case is a very rare condition. No ‘similar’ case have been described in the literature so far.
CONCLUSIONS: Although a carcinoma within a preexisting benign fibroepithelial tumor is extremely rare, it is important to be aware of the possibility of invasive and metastatic disease. PMID: 29460095 [PubMed - as supplied by publisher]
Abstract Lobular carcinoma in situ (LCIS) is a risk factor and a nonobligate precursor of breast carcinoma. The relative risk of invasive carcinoma after classic LCIS diagnosis is approximately 9 to 10 times that of the general population. Classic LCIS diagnosed on core biopsy with concordant imaging and pathologic findings does not mandate surgical excision, and margin status is not reported. The identification of variant LCIS in a needle core biopsy specimen mandates surgical excision, regardless of radiologic-pathologic concordance. The presence of variant LCIS close to the surgical margin of a resection specim...
AbstractPurpose of reviewThe purpose of this review is to describe recent updates in the management of high-risk breast lesions. We review the various high-risk breast lesions and evaluate the collective literature regarding the rates of upgrade to invasive cancer or ductal carcinoma in situ with excisional biopsy as well as the increased risk for future breast cancer development that a diagnosis of a high-risk breast lesion may portend. For those lesions associated with an increased risk of breast cancer, we discuss the appropriate surveillance regimens as well as risk reduction opportunities available to patients.Recent ...
Conclusion Combining DWI, T2WI, and ADC values provides increased accuracy for differentiation between benign and malignant lesions, compared with DCE-MRI. A lower ADC value was associated with a higher histologic grade cancer.