Incidence of Adjacent Synchronous Invasive Carcinoma and/or Ductal Carcinoma In-situ in Patients with Lobular Neoplasia on Core Biopsy: Results from a Prospective Multi-Institutional Registry (TBCRC 020)

Faina Nakhlis, Lauren Gilmore, Rebecca Gelman, Isabelle Bedrosian, Kandice Ludwig, E. Shelley Hwang, Shawna Willey, Clifford Hudis, J. Dirk Iglehart, Elizabeth Lawler, Nicole Y. Ryabin, Mehra Golshan, Stuart J. Schnitt, Tari A. King

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

Background: Lobular neoplasia (LN) represents a spectrum of atypical proliferative lesions, including atypical lobular hyperplasia and lobular carcinoma-in-situ. The need for excision for LN found on core biopsy (CB) is controversial. We conducted a prospective multi-institutional trial (TBCRC 20) to determine the rate of upgrade to cancer after excision for pure LN on CB. Methods: Patients with a CB diagnosis of pure LN were prospectively identified and consented to excision. Cases with discordant imaging and those with additional lesions requiring excision were excluded. Upgrade rates to cancer were quantified on the basis of local and central pathology review. Confidence intervals and sample size were based on exact binomial calculations. Results: A total of 77 of 79 registered patients underwent excision (median age 51 years, range 27–82 years). Two cases (3 %; 95 % confidence interval 0.3–9) were upgraded to cancer (one tubular carcinoma, one ductal carcinoma-in-situ) at excision per local pathology. Central pathology review of 76 cases confirmed pure LN in the CB in all but two cases. In one case, the tubular carcinoma identified at excision was also found in the CB specimen, and in the other, LN was not identified, yielding an upgrade rate of one case (1 %; 95 % CI 0.01–7) by central pathology review. Conclusions: In this prospective study of 77 patients with pure LN on CB, the upgrade rate was 3 % by local pathology and 1 % by central pathology review, demonstrating that routine excision is not indicated for patients with pure LN on CB and concordant imaging findings.

Original languageEnglish (US)
Pages (from-to)722-728
Number of pages7
JournalAnnals of Surgical Oncology
Volume23
Issue number3
DOIs
StatePublished - Mar 1 2016

Fingerprint

Carcinoma, Intraductal, Noninfiltrating
Registries
Carcinoma
Biopsy
Incidence
Neoplasms
Pathology
Adenocarcinoma
Confidence Intervals
Sample Size
Hyperplasia
Prospective Studies

ASJC Scopus subject areas

  • Surgery
  • Oncology

Cite this

Incidence of Adjacent Synchronous Invasive Carcinoma and/or Ductal Carcinoma In-situ in Patients with Lobular Neoplasia on Core Biopsy : Results from a Prospective Multi-Institutional Registry (TBCRC 020). / Nakhlis, Faina; Gilmore, Lauren; Gelman, Rebecca; Bedrosian, Isabelle; Ludwig, Kandice; Hwang, E. Shelley; Willey, Shawna; Hudis, Clifford; Iglehart, J. Dirk; Lawler, Elizabeth; Ryabin, Nicole Y.; Golshan, Mehra; Schnitt, Stuart J.; King, Tari A.

In: Annals of Surgical Oncology, Vol. 23, No. 3, 01.03.2016, p. 722-728.

Research output: Contribution to journalArticle

Nakhlis, F, Gilmore, L, Gelman, R, Bedrosian, I, Ludwig, K, Hwang, ES, Willey, S, Hudis, C, Iglehart, JD, Lawler, E, Ryabin, NY, Golshan, M, Schnitt, SJ & King, TA 2016, 'Incidence of Adjacent Synchronous Invasive Carcinoma and/or Ductal Carcinoma In-situ in Patients with Lobular Neoplasia on Core Biopsy: Results from a Prospective Multi-Institutional Registry (TBCRC 020)', Annals of Surgical Oncology, vol. 23, no. 3, pp. 722-728. https://doi.org/10.1245/s10434-015-4922-4
Nakhlis, Faina ; Gilmore, Lauren ; Gelman, Rebecca ; Bedrosian, Isabelle ; Ludwig, Kandice ; Hwang, E. Shelley ; Willey, Shawna ; Hudis, Clifford ; Iglehart, J. Dirk ; Lawler, Elizabeth ; Ryabin, Nicole Y. ; Golshan, Mehra ; Schnitt, Stuart J. ; King, Tari A. / Incidence of Adjacent Synchronous Invasive Carcinoma and/or Ductal Carcinoma In-situ in Patients with Lobular Neoplasia on Core Biopsy : Results from a Prospective Multi-Institutional Registry (TBCRC 020). In: Annals of Surgical Oncology. 2016 ; Vol. 23, No. 3. pp. 722-728.
@article{f33ad34c25484201b11bdc97c4973afb,
title = "Incidence of Adjacent Synchronous Invasive Carcinoma and/or Ductal Carcinoma In-situ in Patients with Lobular Neoplasia on Core Biopsy: Results from a Prospective Multi-Institutional Registry (TBCRC 020)",
abstract = "Background: Lobular neoplasia (LN) represents a spectrum of atypical proliferative lesions, including atypical lobular hyperplasia and lobular carcinoma-in-situ. The need for excision for LN found on core biopsy (CB) is controversial. We conducted a prospective multi-institutional trial (TBCRC 20) to determine the rate of upgrade to cancer after excision for pure LN on CB. Methods: Patients with a CB diagnosis of pure LN were prospectively identified and consented to excision. Cases with discordant imaging and those with additional lesions requiring excision were excluded. Upgrade rates to cancer were quantified on the basis of local and central pathology review. Confidence intervals and sample size were based on exact binomial calculations. Results: A total of 77 of 79 registered patients underwent excision (median age 51 years, range 27–82 years). Two cases (3 {\%}; 95 {\%} confidence interval 0.3–9) were upgraded to cancer (one tubular carcinoma, one ductal carcinoma-in-situ) at excision per local pathology. Central pathology review of 76 cases confirmed pure LN in the CB in all but two cases. In one case, the tubular carcinoma identified at excision was also found in the CB specimen, and in the other, LN was not identified, yielding an upgrade rate of one case (1 {\%}; 95 {\%} CI 0.01–7) by central pathology review. Conclusions: In this prospective study of 77 patients with pure LN on CB, the upgrade rate was 3 {\%} by local pathology and 1 {\%} by central pathology review, demonstrating that routine excision is not indicated for patients with pure LN on CB and concordant imaging findings.",
author = "Faina Nakhlis and Lauren Gilmore and Rebecca Gelman and Isabelle Bedrosian and Kandice Ludwig and Hwang, {E. Shelley} and Shawna Willey and Clifford Hudis and Iglehart, {J. Dirk} and Elizabeth Lawler and Ryabin, {Nicole Y.} and Mehra Golshan and Schnitt, {Stuart J.} and King, {Tari A.}",
year = "2016",
month = "3",
day = "1",
doi = "10.1245/s10434-015-4922-4",
language = "English (US)",
volume = "23",
pages = "722--728",
journal = "Annals of Surgical Oncology",
issn = "1068-9265",
publisher = "Springer New York",
number = "3",

}

TY - JOUR

T1 - Incidence of Adjacent Synchronous Invasive Carcinoma and/or Ductal Carcinoma In-situ in Patients with Lobular Neoplasia on Core Biopsy

T2 - Results from a Prospective Multi-Institutional Registry (TBCRC 020)

AU - Nakhlis, Faina

AU - Gilmore, Lauren

AU - Gelman, Rebecca

AU - Bedrosian, Isabelle

AU - Ludwig, Kandice

AU - Hwang, E. Shelley

AU - Willey, Shawna

AU - Hudis, Clifford

AU - Iglehart, J. Dirk

AU - Lawler, Elizabeth

AU - Ryabin, Nicole Y.

AU - Golshan, Mehra

AU - Schnitt, Stuart J.

AU - King, Tari A.

PY - 2016/3/1

Y1 - 2016/3/1

N2 - Background: Lobular neoplasia (LN) represents a spectrum of atypical proliferative lesions, including atypical lobular hyperplasia and lobular carcinoma-in-situ. The need for excision for LN found on core biopsy (CB) is controversial. We conducted a prospective multi-institutional trial (TBCRC 20) to determine the rate of upgrade to cancer after excision for pure LN on CB. Methods: Patients with a CB diagnosis of pure LN were prospectively identified and consented to excision. Cases with discordant imaging and those with additional lesions requiring excision were excluded. Upgrade rates to cancer were quantified on the basis of local and central pathology review. Confidence intervals and sample size were based on exact binomial calculations. Results: A total of 77 of 79 registered patients underwent excision (median age 51 years, range 27–82 years). Two cases (3 %; 95 % confidence interval 0.3–9) were upgraded to cancer (one tubular carcinoma, one ductal carcinoma-in-situ) at excision per local pathology. Central pathology review of 76 cases confirmed pure LN in the CB in all but two cases. In one case, the tubular carcinoma identified at excision was also found in the CB specimen, and in the other, LN was not identified, yielding an upgrade rate of one case (1 %; 95 % CI 0.01–7) by central pathology review. Conclusions: In this prospective study of 77 patients with pure LN on CB, the upgrade rate was 3 % by local pathology and 1 % by central pathology review, demonstrating that routine excision is not indicated for patients with pure LN on CB and concordant imaging findings.

AB - Background: Lobular neoplasia (LN) represents a spectrum of atypical proliferative lesions, including atypical lobular hyperplasia and lobular carcinoma-in-situ. The need for excision for LN found on core biopsy (CB) is controversial. We conducted a prospective multi-institutional trial (TBCRC 20) to determine the rate of upgrade to cancer after excision for pure LN on CB. Methods: Patients with a CB diagnosis of pure LN were prospectively identified and consented to excision. Cases with discordant imaging and those with additional lesions requiring excision were excluded. Upgrade rates to cancer were quantified on the basis of local and central pathology review. Confidence intervals and sample size were based on exact binomial calculations. Results: A total of 77 of 79 registered patients underwent excision (median age 51 years, range 27–82 years). Two cases (3 %; 95 % confidence interval 0.3–9) were upgraded to cancer (one tubular carcinoma, one ductal carcinoma-in-situ) at excision per local pathology. Central pathology review of 76 cases confirmed pure LN in the CB in all but two cases. In one case, the tubular carcinoma identified at excision was also found in the CB specimen, and in the other, LN was not identified, yielding an upgrade rate of one case (1 %; 95 % CI 0.01–7) by central pathology review. Conclusions: In this prospective study of 77 patients with pure LN on CB, the upgrade rate was 3 % by local pathology and 1 % by central pathology review, demonstrating that routine excision is not indicated for patients with pure LN on CB and concordant imaging findings.

UR - http://www.scopus.com/inward/record.url?scp=84957851757&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84957851757&partnerID=8YFLogxK

U2 - 10.1245/s10434-015-4922-4

DO - 10.1245/s10434-015-4922-4

M3 - Article

C2 - 26542585

AN - SCOPUS:84957851757

VL - 23

SP - 722

EP - 728

JO - Annals of Surgical Oncology

JF - Annals of Surgical Oncology

SN - 1068-9265

IS - 3

ER -