Lavoué Vincent, Graesslin Olivier, Classe Jean Marc, Fondrinier Eric, Angibeau Hélène, Levêque Jean
Department of Obstetric Gynecology, CHU Tenon, 4 rue de la Chine 75020 Paris, France.
Breast. 2007 Oct;16(5):533-9. doi: 10.1016/j.breast.2007.04.005. Epub 2007 Jul 12.
Lobular neoplasia (LN) is a risk factor for bilateral breast cancer without consensus as to its appropriate management. The authors report on a retrospective multi-institutional study concerning 52 patients in whom a diagnosis of LN was made after core needle biopsy (CNB) and who subsequently underwent surgical excision. The excision specimens revealed seven cases of invasive carcinoma and three cases of ductal carcinoma in situ, indicating an underestimation of lesions at CNB in 19% of cases, and in particular in those patients with pleomorphic LN, and when clinical, radiological masses were detected. This lesion is increasingly being diagnosed by CNB due to widespread screening. Follow-up surgical excision should be performed in order to examine the whole lesion in the case of masses or when the histologic specimen reveals a pleomorphic subtype. In other cases, annual mammographic surveillance should be undertaken due to the persistent long-term risk of developing bilateral breast cancer.
小叶瘤变（LN）是双侧乳腺癌的一个危险因素，但其合适的治疗方法尚无共识。作者报告了一项回顾性多机构研究，该研究涉及52例经粗针穿刺活检（CNB）诊断为LN且随后接受手术切除的患者。切除标本显示7例浸润性癌和3例导管原位癌，表明在19%的病例中CNB低估了病变，特别是在那些具有多形性LN的患者中，以及在检测到临床和影像学肿块的患者中。由于广泛筛查，这种病变越来越多地通过CNB诊断出来。对于有肿块的情况或组织学标本显示为多形性亚型时，应进行后续手术切除以检查整个病变。在其他情况下，由于存在发生双侧乳腺癌的长期持续风险，应进行每年一次的乳腺钼靶监测。
