title: When pathological and radiological correlation is achieved, excision of fibroadenoma with lobular neoplasia on core biopsy is not warranted.
abstract: BACKGROUND
  The diagnosis and management of lobular neoplasia (LN) including lobular carcinoma in situ (LCIS) and atypical lobular hyperplasia (ALH) remains controversial. Current management options after a core needle biopsy (CNB) with lobular neoplasia (LN) incorporating both ALH and LCIS include excision biopsy or careful clinical and radiologic follow up.
  
  
  METHODS
  A retrospective analysis of the surgical database at Cork University Hospital was performed to identify all core needle biopsies from January 1st 2010 to 31st December 2013 with a diagnosis of FA who subsequently underwent surgical excision biopsy. All cases with associated LN including ALH and classical LCIS were selected. We excluded cases with coexistent ductal carcinoma in situ (DCIS), invasive carcinoma, LN associated with necrosis, pleomorphic lobular carcinoma in situ (PLCIS) or lesions which would require excision in their own right (papilloma, radial scar, atypical ductal hyperplasia (ADH) or flat epithelial atypia (FEA)). Cases in which the radiologic targeted mass was discordant with a diagnosis of FA were also excluded.
  
  
  RESULTS
  2878 consecutive CNB with a diagnosis of FA were identified. 25 cases had a diagnosis of concomitant ALH or classical LCIS. Our study cohort consisted of 21 women with a mean age 53 years (age range 41-70 years). The core biopsy diagnosis was of LCIS and FA in 16 cases and ALH and FA in 5 cases. On excision biopsy, a FA was confirmed in all 21 cases. In addition to the FA, residual LCIS was present in 14 cases with residual ALH in 2 cases. One of the twenty-one cases (4.8%) was upgraded to invasive ductal carcinoma on excision.
authors.affiliation: Cork University Hospital, Wilton, Cork, Ireland.
authors.forename: C
authors.initials: C
authors.lastname: Fives
authors.affiliation: Cork University Hospital, Wilton, Cork, Ireland. Electronic address: cathleen.oneill@gmail.com.
authors.forename: C J
authors.initials: CJ
authors.lastname: O'Neill
authors.affiliation: Cork University Hospital, Wilton, Cork, Ireland.
authors.forename: R
authors.initials: R
authors.lastname: Murphy
authors.affiliation: Cork University Hospital, Wilton, Cork, Ireland.
authors.forename: M A
authors.initials: MA
authors.lastname: Corrigan
authors.affiliation: Cork University Hospital, Wilton, Cork, Ireland.
authors.forename: M J
authors.initials: MJ
authors.lastname: O'Sullivan
authors.affiliation: Cork University Hospital, Wilton, Cork, Ireland.
authors.forename: L
authors.initials: L
authors.lastname: Feeley
authors.affiliation: Cork University Hospital, Wilton, Cork, Ireland.
authors.forename: M W
authors.initials: MW
authors.lastname: Bennett
authors.affiliation: Cork University Hospital, Wilton, Cork, Ireland.
authors.forename: F
authors.initials: F
authors.lastname: O'Connell
authors.affiliation: Cork University Hospital, Wilton, Cork, Ireland.
authors.forename: T J
authors.initials: TJ
authors.lastname: Browne
mesh_terms: D000328:Adult; D000359:Aftercare; D000368:Aged; D062005:Biopsy, Large-Core Needle; D000071960:Breast Carcinoma In Situ / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D001943:Breast Neoplasms / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D015331:Cohort Studies; D019468:Disease Management; D005260:Female; D018226:Fibroadenoma / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D006801:Humans; D006965:Hyperplasia; D008327:Mammography; D015412:Mastectomy, Segmental; D008875:Middle Aged; D012189:Retrospective Studies; D057832:Watchful Waiting
keywords: Benign; Breast; Fibroadenoma; LCIS; Lobular carcinoma; Lobular neoplasia; Pathology; Surgery