Ho Bernard Chi-Shern, Tan Puay Hoon
Department of Pathology, Singapore General Hospital, Singapore.
Pathology. 2009 Jan;41(1):28-35. doi: 10.1080/00313020802563494.
Lobular neoplasia, which encompasses both atypical lobular hyperplasia and lobular carcinoma in situ, is traditionally considered a risk lesion that indicates an increased relative risk of the affected woman for subsequent breast cancer development. Recent molecular genetic information on this entity, however, has provided additional insights into the biology of this incompletely understood disease. Recognition of variants of lobular carcinoma in situ has also led to dilemmas in optimal management, and the advent of pre-operative core biopsies for radiologically detected lesions has created uncertainties regarding how best to handle incidentally discovered lobular neoplasia on these biopsy cores. This article provides an overview of existing concepts, diagnostic pitfalls, pathobiology and current management approaches for this enigmatic lesion.
小叶瘤变包括非典型小叶增生和小叶原位癌，传统上被认为是一种风险病变，表明受影响女性患后续乳腺癌的相对风险增加。然而，关于这一实体的最新分子遗传学信息为这种尚未完全理解的疾病的生物学特性提供了更多见解。对小叶原位癌变异型的认识也导致了最佳管理方面的困境，而针对放射学检测到的病变进行术前粗针活检的出现，使得对于如何最好地处理这些活检标本中偶然发现的小叶瘤变产生了不确定性。本文概述了关于这一神秘病变的现有概念、诊断陷阱、病理生物学及当前的管理方法。
