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乳腺非浸润性小叶肿瘤:形态学特征、临床表现及治疗困境。

Non-invasive lobular neoplasia of the breast: Morphologic features, clinical presentation, and management dilemmas.

机构信息

Department of Pathology, Memorial Sloan Kettering Cancer Center, New York City, NY, USA.

Faculdade de Ciencias da Saude da Universidade da Beira Interior, Covilha, Portugal.

出版信息

Breast J. 2020 Jun;26(6):1148-1155. doi: 10.1111/tbj.13857. Epub 2020 Jun 4.

DOI:10.1111/tbj.13857
PMID:32500575
Abstract

The designation of noninvasive lobular neoplasia applies to atypical epithelial proliferations composed of noncohesive cells secondary to loss or functional alteration of E-cadherin-mediated cell adhesion. The morphologic spectrum of noninvasive lobular neoplasia encompasses atypical lobular hyperplasia (ALH) and classic lobular carcinoma in situ (classic LCIS) and two LCIS variants, namely florid LCIS (F-LCIS) and pleomorphic LCIS (P-LCIS), as defined in the World Health Organization (WHO) Classification of Tumors of the Breast 5th ed. Herein, we review the morphologic, immunohistochemical, and molecular features of noninvasive lobular neoplasia, with special emphasis on F-LCIS and P-LCIS. We also review imaging features, management at core needle biopsy, upgrade rates at surgical excision, and clinical management dilemmas.

摘要

非浸润性小叶肿瘤的定义适用于非黏附性细胞的上皮细胞非典型性增生,这些细胞继发于 E-钙黏蛋白介导的细胞黏附丧失或功能改变。非浸润性小叶肿瘤的形态学谱包括不典型小叶增生(ALH)和经典小叶原位癌(经典 LCIS)以及两种 LCIS 变体,即弥漫性 LCIS(F-LCIS)和多形性 LCIS(P-LCIS),这在世界卫生组织(WHO)第 5 版《乳腺肿瘤分类》中有定义。本文中,我们将综述非浸润性小叶肿瘤的形态学、免疫组织化学和分子特征,特别强调 F-LCIS 和 P-LCIS。我们还将综述影像学特征、在核心针活检中的处理、在手术切除中的升级率以及临床管理困境。

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Non-invasive lobular neoplasia of the breast: Morphologic features, clinical presentation, and management dilemmas.乳腺非浸润性小叶肿瘤:形态学特征、临床表现及治疗困境。
Breast J. 2020 Jun;26(6):1148-1155. doi: 10.1111/tbj.13857. Epub 2020 Jun 4.
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The morphologic spectrum of lobular carcinoma in situ (LCIS) observations on clinical significance, management implications and diagnostic pitfalls of classic, florid and pleomorphic LCIS.小叶原位癌(LCIS)的形态学谱:关于经典型、旺炽型和多形性LCIS的临床意义、处理要点及诊断陷阱的观察
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Management of Lobular Neoplasia Diagnosed by Core Biopsy.乳腺叶状肿瘤的核心活检诊断及处理。
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When pathological and radiological correlation is achieved, excision of fibroadenoma with lobular neoplasia on core biopsy is not warranted.当病理与放射学检查结果相互印证时,对于在粗针活检中发现伴有小叶肿瘤的纤维腺瘤,无需进行切除。
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Core Breast Biopsies Showing Lobular Carcinoma In Situ Should Be Excised and Surveillance Is Reasonable for Atypical Lobular Hyperplasia.核心乳腺活检显示小叶原位癌时应行切除术,对不典型小叶增生行监测是合理的。
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Follow-up surgical excision is indicated when breast core needle biopsies show atypical lobular hyperplasia or lobular carcinoma in situ: a correlative study of 33 patients with review of the literature.当乳腺粗针活检显示非典型小叶增生或小叶原位癌时,需进行后续手术切除:33例患者的相关性研究及文献复习
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Management of screening-detected lobular neoplasia in the era of digital breast tomosynthesis: A preliminary study.数字乳腺断层合成摄影时代筛查检出的乳腺小叶肿瘤的管理:一项初步研究。
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Pleomorphic and Florid Lobular Carcinoma In Situ Variants of the Breast: A Clinicopathologic Study of 85 Cases With and Without Invasive Carcinoma From a Single Academic Center.乳腺多形性和华丽型小叶原位癌变异型:来自单一学术中心的 85 例伴有和不伴有浸润性癌的临床病理研究。
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Upgrade Rates of Variant Lobular Carcinoma In Situ Compared to Classic Lobular Carcinoma In Situ Diagnosed in Core Needle Biopsies: A 10-Year Single Institution Retrospective Study.在核心针活检中诊断的经典小叶原位癌与变异型小叶原位癌的升级率比较:一项 10 年单机构回顾性研究。
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引用本文的文献

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Surgery for Classic, Pleomorphic and Non-classic Lobular Carcinoma In Situ: Surgery Rate, Risk of Upstaging and Short-Term Follow-Up.经典型、多形性和非经典型小叶原位癌的手术治疗:手术率、分期升级风险及短期随访
Ann Surg Oncol. 2025 Apr;32(4):2545-2553. doi: 10.1245/s10434-024-16686-8. Epub 2024 Dec 30.
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Immediate and delayed risk of breast cancer associated with classic lobular carcinoma in situ and its variants.经典型乳腺小叶原位癌及其变异型与乳腺癌的即刻和延迟风险。
Breast Cancer Res Treat. 2024 Jun;205(3):545-554. doi: 10.1007/s10549-024-07261-6. Epub 2024 Mar 12.