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Kamaljeet Singh, Cherie Paquette, Elizabeth T Kalife, Yihong Wang, Shamlal Mangray, M Ruhul Quddus Md MPhil, Margaret M Steinhoff
Morphological variants of lobular carcinoma in situ (LCIS) include classical- (CLCIS), pleomorphic- (PLCIS) and florid-type (FLCIS). Treatment guidelines suggest managing PLCIS and FLCIS like ductal carcinoma in situ (DCIS); therefore accurate identification of LCIS subtypes is critical. However significance of separating PLCIS from FLCIS is not clear. Also inter-observer agreement in identifying LCIS subtypes, using contemporary criteria, is not known. We aimed to evaluate inter-observer agreement amongst breast pathologists in diagnosing LCIS subtypes and use the agreement data to justify LCIS classification for management purposes...
May 9, 2018: Human Pathology
Tianhua Guo, Yihong Wang, Nella Shapiro, Susan Fineberg
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...
October 7, 2017: Clinical Breast Cancer
Carolina E Fasola, Jie Jane Chen, Kristin C Jensen, Kimberly H Allison, Kathleen C Horst
Pleomorphic lobular carcinoma in situ (PLCIS) of the breast is a rare variant of lobular carcinoma in situ (LCIS). We reviewed 78 cases of PLCIS diagnosed at our institution from 1998 to 2012. Among all cases, 47 (60%) were associated with invasive carcinoma and/or ductal carcinoma in situ (DCIS) after final surgical excision. Of the 20 cases with PLCIS alone on core needle biopsy (CNB), 6 (30%) were upgraded to invasive carcinoma or DCIS after final surgical excision. Our findings support a recommendation for complete surgical excision of PLCIS when diagnosed on CNB...
January 2018: Breast Journal
Marina De Brot, Starr Koslow Mautner, Shirin Muhsen, Victor P Andrade, Anita Mamtani, Melissa Murray, Dilip Giri, Rita A Sakr, Edi Brogi, Tari A King
PURPOSE: The natural history of pleomorphic lobular carcinoma in situ (PLCIS) remains largely unknown. METHODS: A pathology database search (1995-2012) was performed to identify patients diagnosed with an LCIS variant. Patients with synchronous breast cancer and/or no evidence of pleomorphism were excluded. Original slides were re-evaluated by three pathologists to identify a consensus cohort of PLCIS. Borderline lesions with focal atypia were classified as LCIS with pleomorphic features (LCIS-PF)...
September 2017: Breast Cancer Research and Treatment
Umar Wazir, Ali Wazir, Clive Wells, Kefah Mokbel
Pleomorphic lobular carcinoma in situ (PLCIS) has only recently been identified as a distinct pathological entity within classic lobular carcinoma in situ (CLCIS). As such, there is currently no consensus among clinicians regarding the optimal treatment of this disease. The present study determined the risk of concomitant invasive disease and ductal carcinoma in situ (DCIS) if PLCIS is observed on core needle biopsy (CNB) and collated the evidence regarding the risk of recurrence in relation to surgical margins and adjuvant therapy...
December 2016: Oncology Letters
C Fives, C J O'Neill, R Murphy, M A Corrigan, M J O'Sullivan, L Feeley, M W Bennett, F O'Connell, T J Browne
BACKGROUND: The diagnosis and management of lobular neoplasia (LN) including lobular carcinoma in situ (LCIS) and atypical lobular hyperplasia (ALH) remains controversial. Current management options after a core needle biopsy (CNB) with lobular neoplasia (LN) incorporating both ALH and LCIS include excision biopsy or careful clinical and radiologic follow up. METHODS: A retrospective analysis of the surgical database at Cork University Hospital was performed to identify all core needle biopsies from January 1st 2010 to 31st December 2013 with a diagnosis of FA who subsequently underwent surgical excision biopsy...
December 2016: Breast: Official Journal of the European Society of Mastology
Luis Z Blanco, Tiffany A Thurow, Aparna Mahajan, Barbara Susnik, Irene Helenowski, Joan S Chmiel, Megan E Sullivan
OBJECTIVES: Bi- and multinucleated (B/M) cells are present in a variety of tumors. We evaluated lobular carcinoma in situ (classic and pleomorphic types) and ductal carcinoma in situ (DCIS) to determine if this objective morphologic feature aids the differential diagnosis. METHODS: The number of B/M cells was recorded in pleomorphic lobular carcinoma in situ (PLCIS) (n = 20), classic lobular carcinoma in situ (CLCIS) (n = 26), and DCIS (n = 37). RESULTS: Binucleated cells were significantly more frequent in PLCIS (100%) vs DCIS (43%; P < ...
November 2015: American Journal of Clinical Pathology
Meghan R Flanagan, Mara H Rendi, Kristine E Calhoun, Benjamin O Anderson, Sara H Javid
BACKGROUND: Pleomorphic lobular carcinoma in situ (PLCIS) is an unusual variant of LCIS for which optimal management remains unclear. METHODS: We conducted a 15-year (2000-2014) retrospective chart review of the radiologic, pathologic, clinical management, and recurrence rates of patients with PLCIS on diagnostic biopsy. Fifty-one patients were found to have PLCIS either alone or with concomitant breast cancer. Of these, 23 were found to have pure PLCIS on diagnostic biopsy...
December 2015: Annals of Surgical Oncology
V T Lehman, N S Murthy, F E Diehn, J T Verdoorn, T P Maus
The retrodural space of Okada is situated dorsal to the ligamentum flavum in the interlaminar space, and provides communication between contralateral facet joints. MRI will often demonstrate heterogeneous signal abnormality with contrast enhancement in this space and several communicating compartments of the posterior ligamentous complex: bilateral facet joints, adventitial interspinous bursae, or retrodural cysts penetrating the ligamentum flavum. Pars interarticularis defects are frequently present. This imaging pattern may be associated with axial low back pain and/or radicular pain...
May 2015: Clinical Radiology
Andrew Pieri, James Harvey, Nigel Bundred
The clinical significance of pleomorphic lobular carcinoma in situ (PLCIS) is a subject of controversy. As a consequence, there is a risk of providing inconsistent management to patients presenting with PLCIS. This review aims to establish whether the current guidelines for the management of PLCIS are consistent with current evidence. A systematic electronic search was performed to identify all English language articles regarding PLCIS management. The data was analysed, specifically looking at: incidence of concurrent disease, recurrence rates, long-term prognosis and PLCIS management...
August 10, 2014: World Journal of Clinical Oncology
Stefano Meroni, Meroni Stefano, Anna Carla Bozzini, Bozzini Anna Carla, Giancarlo Pruneri, Pruneri Giancarlo, Oana Codrina Moscovici, Moscovici Oana Codrina, Patrick Maisonneuve, Maisonneuve Patrick, Simona Menna, Menna Simona, Silvia Penco, Penco Silvia, Lorenza Meneghetti, Meneghetti Lorenza, Giuseppe Renne, Renne Giuseppe, Enrico Cassano, Cassano Enrico
OBJECTIVES: To evaluate the underestimation rate and clinical relevance of lobular neoplasia in vacuum-assisted breast biopsy (VABB). METHODS: A total of 161 cases of LN were retrieved from 6,435 VABB. The histological diagnosis was ALH (atypical lobular hyperplasia) in 80 patients, LCIS (lobular carcinoma in situ) in 69 patients and PLCIS (pleomorphic lobular carcinoma in situ) in 12 patients. Seventy-six patients were operated on within 2 years after VABB and 85 were clinically and radiologically monitored...
July 2014: European Radiology
Thaer Khoury, Rouzan G Karabakhtsian, David Mattson, Li Yan, Susanna Syriac, Fadi Habib, Song Liu, Mohamed M Desouki
AIMS: Pleomorphic lobular carcinoma in situ (PLCIS) of the breast is a distinctive entity, but its behaviour and management are unclear. The purpose of this study was to review a relatively large number of cases and to evaluate the risk of recurrence. METHODS AND RESULTS: Cases of PLCIS (n = 47) from a 12-year period were reviewed. The clinical, radiological and pathological findings were recorded. Immunohistochemistry for oestrogen receptor (ER), progesterone receptor (PR) and HER2 was performed...
June 2014: Histopathology
Yazan A Masannat, Salena K Bains, Sarah E Pinder, Arnie D Purushotham
BACKGROUND: Pleomorphic Lobular Carcinoma in Situ (PLCIS) is a pathological variant of Lobular Carcinoma in Situ (LCIS) with distinct features. Since first described over a decade ago there are only few papers published about this condition. METHODS: Medline and Pubmed based literature overview was done with the aim of describing the different histopathological, radiological and clinical features of this pathological entity to highlight the different clinicopathological presentations and modalities of treatment described...
April 2013: Breast: Official Journal of the European Society of Mastology
Jana L Lewis, David Y Lee, Paul I Tartter
BACKGROUND: The significance of lobular neoplasia (LN), lobular carcinoma in situ (LCIS) and atypical lobular hyperplasia (ALH)) found at core needle biopsy (CNB) of the breast remains uncertain. There is a consistent risk of underestimating malignancy after the diagnosis of LN on CNB. The aim of this study was to determine if patients with a CNB result of LN need surgical excision. METHODS: Patients were identified by searching the institutions pathology database for the terms "lobular carcinoma in situ" and "atypical lobular hyperplasia" over 20 years...
December 2012: Annals of Surgical Oncology
Erinn Downs-Kelly, Diana Bell, George H Perkins, Nour Sneige, Lavinia P Middleton
CONTEXT: The appropriate treatment for patients with pleomorphic lobular carcinoma in situ (PLCIS) is unknown. When diagnosed on core biopsy, excision is recommended; however, management of PLCIS when it involves margins has not been addressed. OBJECTIVE: To evaluate the significance of PLCIS that is located close to, or at, a resection margin. DESIGN: We identified 26 patients with resection specimens containing PLCIS, all of whom were offered chemoprevention and radiation therapy...
June 2011: Archives of Pathology & Laboratory Medicine
M Hussain, G H Cunnick
OBJECTIVES: To determine the incidence of malignancy (invasive carcinoma or DCIS) in patients diagnosed with lobular neoplasia (B3) on core needle biopsy (CNB) of breast lesions by reviewing the published literature. METHODS: Medline, Embase, OVID-database and reference lists were searched to identify and review all English-language articles addressing the management of LN diagnosed on CNB. Studies on mixed breast pathologies were excluded. RESULTS: Of 1229 LN diagnosed on CNB, 789 (64%) underwent surgical excision...
April 2011: European Journal of Surgical Oncology
Pauline J Carder, Abeer Shaaban, Yalda Alizadeh, Vidya Kumarasuwamy, Joyce C Liston, Nisha Sharma
AIMS: Pleomorphic lobular carcinoma in situ (PLCIS) is an uncommon, recently recognized variant of lobular carcinoma in situ (LCIS). Its natural history, biological behaviour and clinical characteristics are uncertain. The aim was to review the radiological and pathological findings in a series of screen-detected PLCIS diagnosed on needle core biopsy with a view to determining the diagnostic features, immunohistological profile and risk of concurrent invasive malignancy. METHODS AND RESULTS: Ten cases of core biopsy-diagnosed, screen-detected PLCIS were identified...
September 2010: Histopathology
Yunn-Yi Chen, Eun-Sil Shelley Hwang, Ritu Roy, Sandy DeVries, Joseph Anderson, Chrystal Wa, Patrick L Fitzgibbons, Timothy W Jacobs, Gaetan MacGrogan, Hans Peterse, Anne Vincent-Salomon, Taku Tokuyasu, Stuart J Schnitt, Frederic M Waldman
The clinical, pathologic, and molecular features of pleomorphic lobular carcinoma in situ (PLCIS) and the relationship of PLCIS to classic LCIS (CLCIS) are poorly defined. In this study, we analyzed 31 cases of PLCIS (13 apocrine and 18 nonapocrine subtypes) and compared the clinical, pathologic, immunophenotypic, and genetic characteristics of these cases with those of 24 cases of CLCIS. Biomarker expression was examined using immunostaining for E-cadherin, gross cystic disease fluid protein-15, estrogen, progesterone, androgen receptor, human epidermal growth factor receptor2, CK5/6, and Ki67...
November 2009: American Journal of Surgical Pathology
Alejandro Contreras, Husain Sattar
CONTEXT: Lobular neoplasias (LNs) of the breast include atypical lobular neoplasia and lobular carcinoma in situ. Recent evidence suggests that LN is not only a risk factor for invasive lobular carcinoma, but is also a nonobligate precursor. Pleomorphic lobular carcinoma in situ (PLCIS) is a subtype of LN that has high-grade nuclei and other features that may mimic high-grade ductal carcinoma in situ. The management and follow-up of patients diagnosed with LN on core biopsy is a current issue of debate...
July 2009: Archives of Pathology & Laboratory Medicine
Mamatha Chivukula, Denise M Haynik, Adam Brufsky, Gloria Carter, David J Dabbs
Pleomorphic lobular carcinoma in situ (PLCIS) is a more recently characterized entity that mimics high-grade ductal carcinoma in situ (DCIS). PLCIS is sometimes treated similar to high-grade DCIS, but no consensus has been reached for the most appropriate treatment. The aim of this study is to evaluate the histologic and immunohistologic profile of pure PLCIS on core needle biopsies and present follow-up clinical data. We reviewed 12 cases of pure PLCIS diagnosed on core needle biopsies of the breast along with subsequent surgical resections...
November 2008: American Journal of Surgical Pathology
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