title: Outcomes of patients with lobular in situ neoplasia of the breast: the role of vacuum-assisted biopsy.
abstract: OBJECTIVE
  To audit the outcomes of patients with non-pleomorphic lobular in situ neoplasia (LISN) of the breast and clarify the role of vacuum-assisted biopsy (VAB), surgical biopsy and conservative management for this condition.
  
  
  METHODS
  A single-centre retrospective review of hospital databases covering a 14-year period was performed. Patients with LISN as the most pertinent diagnosis on core needle biopsy (CNB), vacuum-assisted biopsy (VABs) or surgical biopsy were identified. The radiological features, histopathological findings and outcome of subsequent annual mammography were recorded.
  
  
  RESULTS
  Between 1998 and 2012 there were 70 patients with LISN as the most pertinent diagnosis at CNB, VAB or surgery. 52 underwent VAB, typically 18 11-gauge samples. The pathology was upgraded from the preceding 14-gauge CNB in 7 cases. Of 11 patients who underwent surgery after VAB, one (who had undergone a low tissue yield VAB) was upgraded. There were no new breast cancers during a mean annual mammographic follow-up period of 53 months in 40 patients who had VAB with complete radiological-histopathological concordance.
  
  
  CONCLUSIONS
  Provided there is adequate tissue sampling and radiological-pathological concordance, VAB is a safe alternative to open biopsy in the management of non-pleomorphic LISN.
authors: Nightingale Centre and Genesis Prevention Centre, University Hospital of South Manchester, Wythenshawe, Manchester M23 9LT, UK; Breast Unit, Royal Bolton Hospital, Minerva Road, Bolton BL4 0JR, UK. Electronic address: cparkin@doctors.org.uk.
authors: C K E
authors: CK
authors: Parkin
authors: Breast Unit, Royal Bolton Hospital, Minerva Road, Bolton BL4 0JR, UK.
authors: S
authors: S
authors: Garewal
authors: Department of Histopathology, Royal Bolton Hospital, Minerva Road, Bolton BL4 0JR, UK.
authors: P
authors: P
authors: Waugh
authors: Nightingale Centre and Genesis Prevention Centre, University Hospital of South Manchester, Wythenshawe, Manchester M23 9LT, UK; Breast Unit, Royal Bolton Hospital, Minerva Road, Bolton BL4 0JR, UK.
authors: A J
authors: AJ
authors: Maxwell
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy / Q000379:methods; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D002278:Carcinoma in Situ / Q000000981:diagnostic imaging / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D018275:Carcinoma, Lobular / Q000000981:diagnostic imaging / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008327:Mammography; D008485:Medical Audit; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D016896:Treatment Outcome; D014618:Vacuum; D057832:Watchful Waiting
keywords: Breast biopsy; Breast cancer; Lobular neoplasia; Vacuum biopsy