HIGH RISK BREAST DISORDERS:

Lobular Neoplasia

Lobular neoplasia (LN) is a marker for future breast cancer development; it is a spectrum of disease and is subcatgetorized into atypical lobular hyperplasia (ALH) or lobular carcinoma in situ (LCIS)

Pathology: Proliferation of discohesive epithelial cells that distend lobular acini to varying degrees. If >/= 50% specimen involved, the diagnosis is LCIS. If less than 50% involvement, the diagnosis is ALH

Clinical significance: ALH increases breast cancer risk 4x, and LCIS increases breast cancer risk 8-10x, or 1-2% per year

Management depends on pathologic subcategory:

–     ALH: Chemoprevention could be considered

–     LCIS: Lifelong surveillance, chemoprevention, or bilateral prophylactic mastectomy; Recent literature supports conservative management

(Oppong 2011, Ikeda 2010, Georgian-Smith 2014, Sabel 2015)

LCIS image