Are ALH and LCIS Similar Actors on the Cancer Stage?

Background: The term "lobular neoplasia" encompasses a spectrum of pathologic findings that include atypical lobular hyperplasia (ALH) and lobular carcinoma in situ (LCIS). Described as a proliferation of monomorphic cells in the terminal duct lobular unit, ALH is diagnosed when only a few acini are involved, and LCIS is diagnosed when the entire lobular unit is involved. A diagnosis of lobular neoplasia confers an increased risk of breast cancer by up to 10 times, and surgical excision is often performed after the diagnosis is made on core needle biopsy. Objective: To determine the frequency of malignancy of lesions diagnosed as LCIS or ALH on core needle biopsy, and to assess if there is a difference between the two. Methods: Over a 4-year retrospective period, lesions diagnosed as ALH or LCIS on specimens submitted after core needle biopsy were identified from databases associated with 3 different academic medical institutions. For all cases, radiologic studies including mammogram more...