title: [Shall all lobular intraepithelial neoplasia diagnosed on image-guided biopsy require a surgical management?].
abstract: OBJECTIVE
  Lobular intraepithelial neoplasia (LIN) diagnosed on image-guided biopsy may be associated with an undiagnosed cancer. This is called under-diagnosis. The consequence is that management of these lesions is often surgical. But many surgeries finally are unnecessary. The aim of our study was to define criteria to avoid unnecessary surgery.
  
  
  METHODS
  This is a single-center, retrospective after a database collected prospectively study. Fourteen thousand biopsies were analyzed, including 456 diagnosed NLI. Under-diagnosis rates were analyzed according to many criteria. The average duration of following was 45 months.
  
  
  RESULTS
  For atypical lobular hyperplasia (ALH), we obtained 7.6% under-diagnosis and combining several criteria, we got a low risk of cancer (2%). For LCIS, this rate was 23% and any low-risk group could be identified.
  
  
  CONCLUSIONS
  ALH with calcifications≤20 mm, without any atypical lesion associated, histologically focal and whose removal is representative may be safely observed. For other LIN, surgery remains indicated.
authors.affiliation: Centre René-Huguenin, département d'imagerie médicale, 35, rue Dailly, 92210 Saint-Cloud, France. Electronic address: maefischer@gmail.com.
authors.forename: Maeva
authors.initials: M
authors.lastname: Fischer-Hunsinger
authors.affiliation: Centre René-Huguenin, anatomie et cytologie pathologiques, 35, rue Dailly, 92210 Saint-Cloud, France.
authors.forename: Jean-Marc
authors.initials: JM
authors.lastname: Guinebretière
authors.affiliation: Centre René-Huguenin, département de chirurgie oncologique, 35, rue Dailly, 92210 Saint-Cloud, France.
authors.forename: Serge
authors.initials: S
authors.lastname: Lasry
authors.affiliation: Centre René-Huguenin, département d'imagerie médicale, 35, rue Dailly, 92210 Saint-Cloud, France.
authors.forename: Adriana
authors.initials: A
authors.lastname: Langer
authors.affiliation: Centre René-Huguenin, département d'imagerie médicale, 35, rue Dailly, 92210 Saint-Cloud, France.
authors.forename: Hélène
authors.initials: H
authors.lastname: Berment
authors.affiliation: Centre René-Huguenin, département d'imagerie médicale, 35, rue Dailly, 92210 Saint-Cloud, France.
authors.forename: Ibtissem
authors.initials: I
authors.lastname: Nekka
authors.affiliation: Centre René-Huguenin, département d'imagerie médicale, 35, rue Dailly, 92210 Saint-Cloud, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Nodiot
authors.affiliation: Centre René-Huguenin, département d'imagerie médicale, 35, rue Dailly, 92210 Saint-Cloud, France.
authors.forename: Pascal
authors.initials: P
authors.lastname: Cherel
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001940:Breast / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D002114:Calcinosis / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D002278:Carcinoma in Situ / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D018275:Carcinoma, Lobular / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D006965:Hyperplasia / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D061705:Image-Guided Biopsy; D008875:Middle Aged; D011230:Precancerous Conditions / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D019564:Unnecessary Procedures; D057832:Watchful Waiting
keywords: Atypical lobular hyperplasia; Biopsie du sein; Breast biopsy; Breast neoplasms; Carcinomes lobulaires in situ; Chirurgie; Hyperplasies lobulaires atypiques; Lobular carcinoma in situ; Lobular intraepithelial neoplasia; Néoplasies lobulaires; Surgery