A systematic review of surgical biopsy for LCIS found at core needle biopsy - do we have the answer yet?
BACKGROUND
The natural history of lobular carcinoma in-situ (LCIS) suggests that women are at increased risk of subsequent invasive breast cancer. Questions of effective management for women with this lesion have led to the need for evidence-based guidance and, in particular, guidance regarding management after LCIS is found at core needle biopsy (CNB).


METHODS
A systematic review was conducted to determine the most appropriate management for women with LCIS found at CNB. A comprehensive search of the scientific literature was conducted to identify the literature pertaining to this population. Critical appraisal of the literature, data extraction and a narrative synthesis of the results were conducted. The outcome of interest was upgrade of diagnosis to invasive breast cancer or ductal carcinoma in-situ (DCIS).


RESULTS
Sparse data, with limited generalisability and considerable uncertainty, are available for women with LCIS at CNB. Nine studies were identified that met pre-specified inclusion criteria. The reported estimates of upgrade of diagnosis from LCIS to invasive breast cancer or DCIS ranged from 2% to 25%. The body of evidence was limited by its retrospective nature, risk of selection bias and poor generalisability to all women with LCIS at CNB. Further, higher quality research is required to determine the best approach for women with LCIS at CNB with any certainty.
School of Population Health, Division of Health Sciences, University of South Australia, GPO Box 2471, Adelaide, South Australia, Australia. Electronic address: elizabeth.buckley@mymail.unisa.edu.au.
E S
ES
Buckley
Cancer Australia, Locked Bag 3, Strawberry Hills, New South Wales 2012, Australia. Electronic address: Fleur.Webster@canceraustralia.gov.au.
F
F
Webster
Faculty of Health Sciences, Australian Catholic University, Locked Bag 4115, Fitzroy MDC, Fitzroy, Victoria 3065, Australia; School of Population Health, University of Adelaide, 178 North Terrace, Adelaide, South Australia 5000, Australia. Electronic address: Janet.Hiller@acu.edu.au.
J E
JE
Hiller
School of Population Health, Division of Health Sciences, University of South Australia, GPO Box 2471, Adelaide, South Australia, Australia. Electronic address: David.Roder@unisa.edu.au.
D M
DM
Roder
BreastScreen SA, 1 Goodwood Rd, Wayville, South Australia 5034, Australia. Electronic address: Gelareh.Farshid@health.sa.gov.au.
G
G
Farshid
D062005:Biopsy, Large-Core Needle; D001943:Breast Neoplasms / Q000473:pathology / Q000628:therapy*; D002278:Carcinoma in Situ / Q000473:pathology / Q000628:therapy*; D018275:Carcinoma, Lobular / Q000473:pathology / Q000628:therapy*; D018450:Disease Progression; D005260:Female; D006801:Humans
Adult; Breast neoplasm; Female; Needle biopsy; Noninfiltrating intraductal carcinoma