Comparison of outcomes for classic-type lobular carcinoma in situ managed with surgical excision after core biopsy versus observation Journal Article
| Authors: | Matar, R.; Sevilimedu, V.; Park, A.; King, T. A.; Pilewskie, M. |
| Article Title: | Comparison of outcomes for classic-type lobular carcinoma in situ managed with surgical excision after core biopsy versus observation |
| Abstract: | Background: Studies report low upgrade rates following excision for classic-type lobular carcinoma in situ (LCIS) with radiologic-pathologic concordance. Thus, in the absence of other high-risk lesions, observation has become standard. We report long-term outcomes of excision versus observation following a core biopsy diagnosis of classic-type LCIS. Methods: Women with LCIS treated from 2013-2020 and managed with excision or observation were identified from a prospective database. Women with cancer upgrade at excision or history of cancer were excluded. We compared rates and characteristics of subsequent breast cancers by clinical management strategy. Results: Of 312 women, 170 (54%) underwent excision and 142 (46%) were managed with observation. Among the excision group, 36 of 170 (21%) had radiologic-pathologic concordant LCIS without other high-risk lesions, mass, or symptoms (concordant LCIS excision group). Overall, at 3.1 years median follow-up, 11 (6.5%) women managed with excision and 11 (7.7%) women managed with observation developed cancer. Cancer development was not associated with management choice (overall excision cohort vs. observation group [p = 0.8]) and did not differ between the concordant LCIS excision and observation groups (p > 0.9). The 5-year cancer development rate was 8.9% (95% confidence interval [CI]: 2.3–31.6%) in the concordant LCIS excision group and 10.3% (95% CI 5.5–18.6%) in the observation group. Conclusions: No difference in breast cancer rates existed among women with a core-biopsy diagnosis of classic-type LCIS managed with excision or observation. These data support management of LCIS as a risk factor, with consideration of chemoprophylaxis, rather than as an indication for surgical excision. © 2021, Society of Surgical Oncology. |
| Keywords: | adult; controlled study; middle aged; cancer surgery; major clinical study; comparative study; follow up; diagnostic imaging; breast neoplasms; breast tumor; carcinoma in situ; breast surgery; breast biopsy; clinical observation; lobular carcinoma in situ; carcinoma, lobular; clinical outcome; lobular carcinoma; invasive ductal carcinoma; human epidermal growth factor receptor 2 positive breast cancer; biopsy, large-core needle; large core needle biopsy; humans; human; female; article; breast carcinoma in situ; hormone receptor-positive, her2-negative breast cancer; classic type lobular carcinoma in situ; ductal breast carcinoma in situ; invasive lobular breast carcinoma |
| Journal Title: | Annals of Surgical Oncology |
| Volume: | 29 |
| Issue: | 3 |
| ISSN: | 1068-9265 |
| Publisher: | Springer |
| Date Published: | 2022-03-01 |
| Start Page: | 1670 |
| End Page: | 1679 |
| Language: | English |
| DOI: | 10.1245/s10434-021-10828-y |
| PUBMED: | 34671879 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Article -- Export Date: 1 March 2022 -- Source: Scopus |
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