title: Low frequency of cancer occurrence in same breast quadrant diagnosed with lobular neoplasia at percutaneous needle biopsy.
abstract: OBJECTIVE
  To determine the type of mammographic abnormality leading to needle biopsy of lobular neoplasia (LN) and define the clinical evolution of low-risk LN lesions diagnosed at needle biopsy but not surgically removed.
  
  
  METHODS
  This study was approved by the institutional review board, and the requirement to obtain informed consent was waived. Among 16 945 needle biopsies performed between April 1998 and August 2008, LN was determined to be the most suspicious lesion in 352 samples (2.1%) (pleomorphic and necrotic forms were excluded). Among 299 pure LN lesions that were not surgically removed, follow-up was available for 276 lesions in 275 women.
  
  
  RESULTS
  Needle biopsy was performed because of mammographic calcifications in 215 of the 276 lesions (77.9%) and because of mammographic masses in 35 (12.7%). The mean follow-up was 5.0 years ± 2.4 (range, 0.6-12.2 years). All 275 women underwent one mammographic follow-up, 205 (74.5%) underwent a second mammographic follow-up, and 147 (53.5%) underwent a third mammographic follow-up. Cancer was diagnosed in 27 of the 275 cases (9.8%) after a mean of 3.9 years ± 2.6 (range, 1.2-10.8 years). Only three cancers (1.1%) occurred in the same breast quadrant as the one originally diagnosed with LN at needle biopsy.
  
  
  CONCLUSIONS
  Lumpectomy of pure LN lesions may not prevent malignancy in most cases. Consequently, women with pure LN of a low-risk type diagnosed at needle biopsy are strongly encouraged to undergo a yearly breast clinical examination and yearly mammographic follow-up to detect an eventual cancer in its early stages.
authors.affiliation: Centre des Maladies du Sein Deschênes-Fabia, Hôpital du Saint-Sacrement, 1050 Chemin Ste-Foy, Quebec City, QC, Canada G1S 4L8. louise.provencher.cha@ssss.gouv.qc.ca
authors.forename: Louise
authors.initials: L
authors.lastname: Provencher
authors.forename: Simon
authors.initials: S
authors.lastname: Jacob
authors.forename: Gary
authors.initials: G
authors.lastname: Côté
authors.forename: Jean-Charles
authors.initials: JC
authors.lastname: Hogue
authors.forename: Christine
authors.initials: C
authors.lastname: Desbiens
authors.forename: Brigitte
authors.initials: B
authors.lastname: Poirier
authors.forename: Isabelle
authors.initials: I
authors.lastname: Raîche
authors.forename: Linda
authors.initials: L
authors.lastname: Le Régent
authors.forename: Caroline
authors.initials: C
authors.lastname: Diorio
mesh_terms: D000328:Adult; D000368:Aged; D001707:Biopsy, Needle; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D018275:Carcinoma, Lobular / Q000000981:diagnostic imaging / Q000473:pathology*; D016001:Confidence Intervals; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008327:Mammography; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging / Q000473:pathology*; D012189:Retrospective Studies