Management of breast lobular carcinoma in situ: radio-pathological correlation, clinical implications, and follow-up.
OBJECTIVE
To show management of patients with breast lobular carcinoma in situ (LCIS).


METHODS
This study is the retrospective review of 65 patients, between 1996 and 2012, with isolated LCIS of the breast, evaluated through clinical examination, ultrasound, and mammography at the first examination and follow-up.


RESULTS
In 53 patients (81.54%), clinical examination was negative. In 14/65 (21.54%) cases, ultrasound was positive and led to biopsy. The clusters of tiny calcifications were the predominant mammographic pattern (45 cases, 69.23%). Forty-six patients (70.77%) underwent surgical biopsy after guided stereotactic placement of metallic marker (hook-wire), 12 (18.46%) by stereotactic vacuum biopsy (SVB), 5 (7.69%) by core needle biopsy (CNB) under ultrasound guidance, two (3.08%) patients CNB with clinically palpable nodules. Fourteen (21.54%) women underwent a quadrantectomy or total mastectomy after the first diagnosis; in this latter group follow-up was negative. Among the 51 patients (78.46%) who did not undergo quadrantectomy or total mastectomy, five relapses occurred, respectively, three LCIS and two infiltrating ductal carcinomas (IDC). Follow-up ranged from 12 to 144 months.


CONCLUSIONS
LCIS is a risk factor for invasive carcinoma and should be managed with careful follow-up, but if there is a discrepancy between pathology and imaging, surgical excision is mandatory.
G
G
Capobianco
L
L
Simbula
D
D
Soro
F
F
Meloni
P
P
Cossu-Rocca
S
S
Dessole
G
G
Ambrosini
P L
PL
Cherchi
G B
GB
Meloni
D000328:Adult; D000368:Aged; D001706:Biopsy; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000601:surgery; D002278:Carcinoma in Situ / Q000175:diagnosis* / Q000601:surgery; D018275:Carcinoma, Lobular / Q000175:diagnosis* / Q000601:surgery; D005260:Female; D006801:Humans; D008327:Mammography; D008408:Mastectomy; D015412:Mastectomy, Segmental; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D012189:Retrospective Studies; D016896:Treatment Outcome; D016217:Ultrasonography, Mammary; D055815:Young Adult