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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.
Source: Current Surgery Reports - Category: Surgery Source Type: research

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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...
Source: Clinical Breast Cancer - Category: Cancer & Oncology Authors: Tags: Surg Pathol Clin Source Type: research
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 ...
Source: Current Radiology Reports - Category: Radiology Source Type: research
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.
Source: Academic Radiology - Category: Radiology Source Type: research
ConclusionsSurgical excision of LN yields a low upgrade rate when careful consideration is given to radiologic/pathologic correlation to exclude cases of discordance. Observation with interval breast imaging is a reasonable alternative for most cases.
Source: Breast Cancer Research and Treatment - Category: Cancer & Oncology Source Type: research
Lobular carcinoma in situ and invasive lobular breast cancer are characterized by enhanced expression of transcription factor AP-2β Laboratory Investigation 98, 117 (January 2018). doi:10.1038/labinvest.2017.106 Authors: Mieke Raap, Malte Gronewold, Henriette Christgen, Silke Glage, Mohammad Bentires-Alj, Shany Koren, Patrick W Derksen, Mirjam Boelens, Jos Jonkers, Ulrich Lehmann, Friedrich Feuerhake, Elna Kuehnle, Oleg Gluz, Ronald Kates, Ulrike Nitz, Nadia Harbeck, Hans H Kreipe &Matthias Christgen
Source: Laboratory Investigation - Category: Laboratory Medicine Authors: Source Type: research
Author Affiliations open 1Epidemiology Branch, National Institute of Environmental Health Sciences (NIEHS), National Institutes of Health (NIH), Department of Health and Human Services (DHHS), Research Triangle Park, North Carolina, USA 2Social &Scientific Systems, Inc., Durham, North Carolina, USA 3Westat, Durham, North Carolina, USA 4Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway 5Biostatistics and Computational Biology Branch, NIEHS, NIH, DHHS, Research Triangle Park, North Carolina, USA PDF Version (548 KB) Abstract About This Article Supplemental Material Bac...
Source: EHP Research - Category: Environmental Health Authors: Tags: Research Source Type: research
AbstractBackgroundBreast cancer screening with magnetic resonance imaging (MRI) may be a useful adjunct to screening mammography in high-risk women, but MRI uptake may be increasing rapidly among low- and average-risk women for whom benefits are unestablished. Comparatively little is known about use of screening MRI in community practice.ObjectiveTo assess relative utilization of MRI among women who do and do not meet professional society guidelines for supplemental screening, and describe utilization according to breast cancer risk indications.DesignProspective cohort study conducted between 2007 and 2014.ParticipantsIn f...
Source: Journal of General Internal Medicine - Category: Internal Medicine Source Type: research
CONCLUSIONSIn patients who had an initial diagnosis of atypical hyperplasia or lobular carcinoma in situ on core biopsy, the 7‐year cumulative breast cancer incidence was 9.9%. Most tumors were ipsilateral, stage I, estrogen receptor‐positive, invasive carcinomas. The current data support close clinical and radiologic follow‐up for more than 5 years in this patient population. Cancer 2017. © 2017 American Cancer Society.
Source: Cancer - Category: Cancer & Oncology Authors: Tags: Original Article Source Type: research
This study aimed to evaluate the clinicopathological characteristics of pregnancy-associated breast cancer (PABC) in comparison with non-pregnancy associated breast cancer (non-PABC). METHODS: A total of 344 eligible patients with PABC were identified in the Korean Breast Cancer Society Registry database. PABC was defined as ductal carcinoma in situ, invasive ductal carcinoma, or invasive lobular carcinoma diagnosed during pregnancy or within 1 year after the birth of a child. Patients with non-PABC were selected from the same database using a 1:2 matching method. The matching variables were operation, age, and initial...
Source: Journal of Breast Cancer - Category: Cancer & Oncology Tags: J Breast Cancer Source Type: research
Conclusions: Increased MD is more strongly associated with H2P tumors when compared with LA. Impact: Delineating risk factors specific to breast cancer subtype may promote development of individualized risk prediction models and screening strategies. Cancer Epidemiol Biomarkers Prev; 26(10); 1487–92. ©2017 AACR.
Source: Cancer Epidemiology Biomarkers and Prevention - Category: Cancer & Oncology Authors: Tags: Research Articles Source Type: research
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