Pleomorphic Lobular Carcinoma in Situ Diagnosed by Breast Core Biopsy

Clinicopathologic Features and Correlation With Subsequent Excision

Tianhua Guo, Yihong Wang, Nella Shapiro, Susan A. Fineberg

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Introduction: Pleomorphic lobular carcinoma in situ (PLCIS) is a variant of LCIS with high-grade morphologic features. The number of case series studying PLCIS is limited, and clinical management of patients with PLCIS is controversial. We report a breast core biopsy (BCBx) series of PLCIS. Materials and Methods: We reviewed 37 cases of PLCIS with or without microinvasion diagnosed by BCBx. PLCIS was defined as dyscohesive cells showing acinar expansion and loss of immunohistochemical membranous expression of e-cadherin or beta-catenin with nuclear pleomorphism with at least 2- to 3-fold variation in nuclear size, membrane irregularities, and variably prominent nucleoli. Clinical information and findings on excision were evaluated. Results: Thirty-one (84%) patients presented with mammographic calcifications, 4 (11%) presented with ultrasound findings, 1 (3%) presented with magnetic resonance imaging enhancement, and 1 (3%) with combined imaging abnormality. The mean patient age was 62.3 years. Nineteen patients (51%) had a family history of breast cancer. Microinvasion was present on BCBx in 9 (24%) of the 37 patients. Excision, available in 34 patients, demonstrated invasive carcinoma in 24 (65%), which was multifocal in 11 (46%). Twenty-three patients with PLCIS without microinvasion on BCBx, and without known history of ipsilateral invasive cancer, underwent excision; 14 of these patients demonstrated invasive carcinoma, representing an upgrade to invasive carcinoma of 60%. Conclusion: We report the largest BCBx series of PLCIS and confirm its aggressive biology and frequent association with multifocal invasive lobular carcinoma, as well as frequent presentation in patients with a family history of breast cancer. Our results support excision to negative margins.

Original languageEnglish (US)
JournalClinical Breast Cancer
DOIs
StateAccepted/In press - Jan 1 2017

Fingerprint

Breast
Biopsy
Carcinoma
Breast Neoplasms
Lobular Carcinoma
Breast Carcinoma In Situ
Acinar Cells
Nuclear Envelope
beta Catenin
Cadherins
Magnetic Resonance Imaging
Neoplasms

Keywords

  • Breast
  • In situ carcinoma
  • Lobular neoplasia

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

@article{0e747b80b9564612b7e640337c99b1cc,
title = "Pleomorphic Lobular Carcinoma in Situ Diagnosed by Breast Core Biopsy: Clinicopathologic Features and Correlation With Subsequent Excision",
abstract = "Introduction: Pleomorphic lobular carcinoma in situ (PLCIS) is a variant of LCIS with high-grade morphologic features. The number of case series studying PLCIS is limited, and clinical management of patients with PLCIS is controversial. We report a breast core biopsy (BCBx) series of PLCIS. Materials and Methods: We reviewed 37 cases of PLCIS with or without microinvasion diagnosed by BCBx. PLCIS was defined as dyscohesive cells showing acinar expansion and loss of immunohistochemical membranous expression of e-cadherin or beta-catenin with nuclear pleomorphism with at least 2- to 3-fold variation in nuclear size, membrane irregularities, and variably prominent nucleoli. Clinical information and findings on excision were evaluated. Results: Thirty-one (84{\%}) patients presented with mammographic calcifications, 4 (11{\%}) presented with ultrasound findings, 1 (3{\%}) presented with magnetic resonance imaging enhancement, and 1 (3{\%}) with combined imaging abnormality. The mean patient age was 62.3 years. Nineteen patients (51{\%}) had a family history of breast cancer. Microinvasion was present on BCBx in 9 (24{\%}) of the 37 patients. Excision, available in 34 patients, demonstrated invasive carcinoma in 24 (65{\%}), which was multifocal in 11 (46{\%}). Twenty-three patients with PLCIS without microinvasion on BCBx, and without known history of ipsilateral invasive cancer, underwent excision; 14 of these patients demonstrated invasive carcinoma, representing an upgrade to invasive carcinoma of 60{\%}. Conclusion: We report the largest BCBx series of PLCIS and confirm its aggressive biology and frequent association with multifocal invasive lobular carcinoma, as well as frequent presentation in patients with a family history of breast cancer. Our results support excision to negative margins.",
keywords = "Breast, In situ carcinoma, Lobular neoplasia",
author = "Tianhua Guo and Yihong Wang and Nella Shapiro and Fineberg, {Susan A.}",
year = "2017",
month = "1",
day = "1",
doi = "10.1016/j.clbc.2017.10.004",
language = "English (US)",
journal = "Clinical Breast Cancer",
issn = "1526-8209",
publisher = "Elsevier",

}

TY - JOUR

T1 - Pleomorphic Lobular Carcinoma in Situ Diagnosed by Breast Core Biopsy

T2 - Clinicopathologic Features and Correlation With Subsequent Excision

AU - Guo, Tianhua

AU - Wang, Yihong

AU - Shapiro, Nella

AU - Fineberg, Susan A.

PY - 2017/1/1

Y1 - 2017/1/1

N2 - Introduction: Pleomorphic lobular carcinoma in situ (PLCIS) is a variant of LCIS with high-grade morphologic features. The number of case series studying PLCIS is limited, and clinical management of patients with PLCIS is controversial. We report a breast core biopsy (BCBx) series of PLCIS. Materials and Methods: We reviewed 37 cases of PLCIS with or without microinvasion diagnosed by BCBx. PLCIS was defined as dyscohesive cells showing acinar expansion and loss of immunohistochemical membranous expression of e-cadherin or beta-catenin with nuclear pleomorphism with at least 2- to 3-fold variation in nuclear size, membrane irregularities, and variably prominent nucleoli. Clinical information and findings on excision were evaluated. Results: Thirty-one (84%) patients presented with mammographic calcifications, 4 (11%) presented with ultrasound findings, 1 (3%) presented with magnetic resonance imaging enhancement, and 1 (3%) with combined imaging abnormality. The mean patient age was 62.3 years. Nineteen patients (51%) had a family history of breast cancer. Microinvasion was present on BCBx in 9 (24%) of the 37 patients. Excision, available in 34 patients, demonstrated invasive carcinoma in 24 (65%), which was multifocal in 11 (46%). Twenty-three patients with PLCIS without microinvasion on BCBx, and without known history of ipsilateral invasive cancer, underwent excision; 14 of these patients demonstrated invasive carcinoma, representing an upgrade to invasive carcinoma of 60%. Conclusion: We report the largest BCBx series of PLCIS and confirm its aggressive biology and frequent association with multifocal invasive lobular carcinoma, as well as frequent presentation in patients with a family history of breast cancer. Our results support excision to negative margins.

AB - Introduction: Pleomorphic lobular carcinoma in situ (PLCIS) is a variant of LCIS with high-grade morphologic features. The number of case series studying PLCIS is limited, and clinical management of patients with PLCIS is controversial. We report a breast core biopsy (BCBx) series of PLCIS. Materials and Methods: We reviewed 37 cases of PLCIS with or without microinvasion diagnosed by BCBx. PLCIS was defined as dyscohesive cells showing acinar expansion and loss of immunohistochemical membranous expression of e-cadherin or beta-catenin with nuclear pleomorphism with at least 2- to 3-fold variation in nuclear size, membrane irregularities, and variably prominent nucleoli. Clinical information and findings on excision were evaluated. Results: Thirty-one (84%) patients presented with mammographic calcifications, 4 (11%) presented with ultrasound findings, 1 (3%) presented with magnetic resonance imaging enhancement, and 1 (3%) with combined imaging abnormality. The mean patient age was 62.3 years. Nineteen patients (51%) had a family history of breast cancer. Microinvasion was present on BCBx in 9 (24%) of the 37 patients. Excision, available in 34 patients, demonstrated invasive carcinoma in 24 (65%), which was multifocal in 11 (46%). Twenty-three patients with PLCIS without microinvasion on BCBx, and without known history of ipsilateral invasive cancer, underwent excision; 14 of these patients demonstrated invasive carcinoma, representing an upgrade to invasive carcinoma of 60%. Conclusion: We report the largest BCBx series of PLCIS and confirm its aggressive biology and frequent association with multifocal invasive lobular carcinoma, as well as frequent presentation in patients with a family history of breast cancer. Our results support excision to negative margins.

KW - Breast

KW - In situ carcinoma

KW - Lobular neoplasia

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SN - 1526-8209

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