Morphological parameters of lobular in situ neoplasia in stereotactic 11-gauge vacuum-assisted needle core biopsy do not predict the presence of malignancy on subsequent surgical excision

Simonetta Bianchi, Benedetta Bendinelli, Isabella Castellano, Quirino Piubello, Giuseppe Renne, Maria Grazia Cattani, Domenica Di Stefano, Giovanna Carrillo, Licia Laurino, Alessandra Bersiga, Carmela Giardina, Stefania Dante, Carla Di Loreto, Carmela Quero, Concetta Maria Antonacci, Domenico Palli

Research output: Contribution to journalArticle

Abstract

Aims: The management of lobular in situ neoplasia (LN) when diagnosed on core biopsy remains a controversial issue. The present study aimed to investigate the association between morphological parameters of LN on vacuum-assisted needle core biopsy (VANCB) and the presence of malignancy (ductal carcinoma in situ, pleomorphic lobular carcinoma in situ, or invasive carcinoma) at surgical excision (SE). Methods and results: The study included 14 pathology departments in Italy. Available slides from 859 cases of VANCB reporting an original diagnosis of flat epithelial atypia, atypical ductal hyperplasia or LN, all with subsequent surgical excision, were reviewed. Overall, 286 cases of LN, pure or associated with other lesions, were identified, and a malignant outcome was reported at excision for 51 cases (17.8%). Among the 149 cases of pure LN, an increased risk of malignancy emerged in women in mammographic categories R4-R5 as compared with those in categories R2-R3 (OR 2.46; P = 0.048). In the series, a statistically significant decreased malignancy risk emerged among cases without determinant microcalcifications (P = 0.04). Conclusions: Our results suggest that the diagnosis of pure LN on VANCB warrants follow-up excision, because clinicopathological parameters do not allow the prediction of which cases will present carcinoma at surgical excision.

Original languageEnglish
Pages (from-to)83-95
Number of pages13
JournalHistopathology
Volume63
Issue number1
DOIs
Publication statusPublished - Jul 2013

Keywords

  • Lobular in situ neoplasia
  • Malignancy
  • Surgical excision
  • Vacuum-assisted needle core biopsy

ASJC Scopus subject areas

  • Histology
  • Pathology and Forensic Medicine

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    Bianchi, S., Bendinelli, B., Castellano, I., Piubello, Q., Renne, G., Cattani, M. G., Stefano, D. D., Carrillo, G., Laurino, L., Bersiga, A., Giardina, C., Dante, S., Loreto, C. D., Quero, C., Antonacci, C. M., & Palli, D. (2013). Morphological parameters of lobular in situ neoplasia in stereotactic 11-gauge vacuum-assisted needle core biopsy do not predict the presence of malignancy on subsequent surgical excision. Histopathology, 63(1), 83-95. https://doi.org/10.1111/his.12139