Outcomes of patients with lobular in situ neoplasia of the breast: the role of vacuum-assisted biopsy

Breast. 2014 Oct;23(5):651-5. doi: 10.1016/j.breast.2014.06.016. Epub 2014 Jul 22.

Abstract

Objectives: 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.

Materials and method: 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.

Conclusion: 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.

Keywords: Breast biopsy; Breast cancer; Lobular neoplasia; Vacuum biopsy.

Publication types

  • Evaluation Study

MeSH terms

  • Adult
  • Aged
  • Biopsy / methods
  • Breast Neoplasms / diagnostic imaging
  • Breast Neoplasms / mortality
  • Breast Neoplasms / pathology*
  • Breast Neoplasms / surgery
  • Carcinoma in Situ / diagnostic imaging
  • Carcinoma in Situ / mortality
  • Carcinoma in Situ / pathology*
  • Carcinoma in Situ / surgery
  • Carcinoma, Lobular / diagnostic imaging
  • Carcinoma, Lobular / mortality
  • Carcinoma, Lobular / pathology*
  • Carcinoma, Lobular / surgery
  • Female
  • Follow-Up Studies
  • Humans
  • Mammography
  • Medical Audit
  • Middle Aged
  • Prognosis
  • Retrospective Studies
  • Treatment Outcome
  • Vacuum
  • Watchful Waiting