Lobular Carcinoma In Situ during Preoperative Biopsy and the Rate of Upgrade

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Authors: Jeea Lee ; Ga Yoon Ku ; Haemin Lee ; Hyung Seok Park ; Ja Seung Ku ; Jee Ye Kim ; Seho Park ; Byeong-Woo Park

MeSH: Biopsy ; Breast Carcinoma In Situ* / diagnosis ; Breast Carcinoma In Situ* / pathology ; Breast Carcinoma In Situ* / surgery ; Breast Neoplasms* / diagnosis ; Breast Neoplasms* / surgery ; Calcinosis* / diagnosis ; Calcinosis* / surgery ; Carcinoma in Situ* / pathology ; Carcinoma, Intraductal, Noninfiltrating* / diagnosis ; Carcinoma, Intraductal, Noninfiltrating* / pathology ; Carcinoma, Intraductal, Noninfiltrating* / surgery ; Carcinoma, Lobular* / diagnosis ; Carcinoma, Lobular* / pathology ; Carcinoma, Lobular* / surgery ; Female ; Humans ; Receptors, Progesterone

Keywords: Breast carcinoma in situ ; Breast neoplasms ; Core needle biopsy ; Lobular carcinoma in situ ; Surgical diagnostic technics

Abstract: Purpose: There is a potential risk that lobular carcinoma in situ (LCIS) on preoperative biopsy might be diagnosed as ductal carcinoma in situ (DCIS) or invasive carcinoma in the final pathology. This study aimed to evaluate the rate of upgrade of LCIS on preoperative biopsy to DCIS or invasive carcinoma.

Materials and methods: Data of 55 patients with LCIS on preoperative biopsy were analyzed. All patients underwent surgery between 1991 and 2016 at Severance Hospital in Seoul, Korea. We analyzed the rate of upgrade of preoperative LCIS to DCIS or invasive cancer in the final pathology. The clinicopathologic features related to the upgrade were evaluated.

Results: The rate of upgrade of LCIS to DCIS or invasive carcinoma was 16.4% (9/55). In multivariate analysis, microcalcification and progesterone receptor expression were significantly associated with the upgrade of LCIS (p=0.023 and p=0.044, respectively).

Conclusion: The current study showed a relatively high rate of upgrade of LCIS on preoperative biopsy to DCIS or invasive cancer. The presence of microcalcification and progesterone receptor expression may be potential predictors of upgradation of LCIS on preoperative biopsy. Surgical excision of the LCIS during preoperative biopsy could be a management option to identify the concealed malignancy.