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Open Surgical Biopsy Not Recommended for Lobular Neoplasia: Presented at ACS
By John Gever
NEW ORLEANS, LA -- October 15, 2007 -- Open surgical biopsy and excision are not worthwhile in the treatment of lobular neoplasia (LN), a precursor of invasive breast cancer, according to research reported here at the 93rd Annual Clinical Congress of the American College of Surgeons (ACS).
Most women diagnosed with LN after core needle biopsy do not develop overt breast cancer within the next several years, according to a study presented here October 9 by Vance Sohn, MD, General Surgery Resident, Madigan Army Medical Center, Tacoma, Washington, United States.
Dr. Sohn and colleagues reviewed records of 50 women with LN, including 42 who had received a diagnosis of atypical LN and eight with lobular carcinoma in situ (LCIS). Immediate excision was performed in 21 cases due to suspicious radiographic findings or surgeon or patient preference, according to the records. The lesions in another 18 were excised at least 3 months after the LN diagnosis, and the remaining 11 (all with atypical LN) had no further procedures and were simply observed for a mean of 21 months.
No malignancies were found in the patients undergoing immediate excision of lesions, and none were later diagnosed in the women who were not treated. Among the 18 who underwent delayed excision, four eventually developed malignancies. These were detected 22-107 months after the excision was performed. One of these tumours developed in the other breast from where the original LN lesion was located; one other was in a different location in the same breast.
There were no marked differences in outcome between the patients with LCIS and those with atypical LN.
"Based on our data, we cannot recommend that patients with a diagnosis of lobular neoplasia...routinely undergo an open surgical biopsy," the authors concluded. "Lobular neoplasia should only be considered a sign of increased risk for future invasive breast cancer."
[Presentation title: Lobular Neoplasia: Is Surgical Excision Warranted?]
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