Lobular carcinoma in situ at percutaneous breast biopsy: surgical biopsy findings

AJR Am J Roentgenol. 1999 Aug;173(2):291-9. doi: 10.2214/ajr.173.2.10430122.


Objective: The purpose of this study was to review surgical histologic findings in women with lobular carcinoma in situ (LCIS) at percutaneous breast biopsy.

Materials and methods: Retrospective review was performed of 1315 consecutive lesions that underwent percutaneous breast biopsy. Percutaneous biopsy yielded LCIS in 16 (1.2%) lesions. Subsequent surgical biopsy was performed in 14 lesions in 13 women. Histologic findings were reviewed.

Results: In five of the 14 lesions, percutaneous biopsy yielded LCIS and a high-risk lesion (radial scar in three and atypical ductal hyperplasia in two); in one (20%) of these five lesions, surgery revealed ductal carcinoma in situ (DCIS). In four of the 14 lesions, the LCIS in the percutaneous biopsy had features that overlapped with those of DCIS; in two (50%) of these four lesions, surgery revealed DCIS (n = 1) or infiltrating lobular carcinoma (n = 1). In the remaining five of the 14 lesions, surgery revealed no DCIS or infiltrating carcinoma. Five (38%) of 13 women with LCIS lesions had synchronous or metachronous infiltrating carcinoma (three ductal, one lobular, one mixed) in the ipsilateral (n = 1) or contralateral (n = 4) breast.

Conclusion: Surgical excision was warranted in lesions in which LCIS was found at percutaneous breast biopsy when the percutaneous biopsy histologic features overlapped with those of DCIS, when a high-risk lesion was present, or when there was imaging-histologic discordance. LCIS without these factors was not shown to require surgical excision in our small series, but a larger study is needed. Diagnosis of LCIS at percutaneous biopsy is a marker for women who are at increased risk of ductal or lobular carcinoma in either breast.

MeSH terms

  • Adult
  • Aged
  • Biopsy, Needle / instrumentation
  • Biopsy, Needle / methods
  • Biopsy, Needle / statistics & numerical data
  • Breast / pathology
  • Breast / surgery
  • Breast Neoplasms / diagnostic imaging
  • Breast Neoplasms / pathology*
  • Breast Neoplasms / surgery
  • Carcinoma in Situ / diagnostic imaging
  • Carcinoma in Situ / pathology*
  • Carcinoma in Situ / surgery
  • Carcinoma, Intraductal, Noninfiltrating / diagnostic imaging
  • Carcinoma, Intraductal, Noninfiltrating / pathology
  • Carcinoma, Intraductal, Noninfiltrating / surgery
  • Carcinoma, Lobular / diagnostic imaging
  • Carcinoma, Lobular / pathology*
  • Carcinoma, Lobular / surgery
  • Female
  • Humans
  • Hyperplasia / diagnostic imaging
  • Hyperplasia / pathology
  • Hyperplasia / surgery
  • Middle Aged
  • Retrospective Studies
  • Ultrasonography, Interventional
  • Ultrasonography, Mammary