Lobular carcinoma in situ on core biopsy - What is the clinical significance?

AIM: To retrospectively review the surgical histological findings in all ca ses where lobular carcinoma in situ (LCIS) was identified on percutaneous c ore biopsy (CB) performed as part of the Cambridge and Huntingdon breast sc reening programme. MATERIALS AND METHODS: We retrospectively reviewed all the core biopsies pe rformed in our department for screen detected abnormalities over a 5-year p eriod between 1 April 1994 and 31 March 1999, All patients where LCIS was i dentified on CB were reviewed. As the significance of LCIS on CE was unclea r all went on to surgical excision. We reviewed the clinical and imaging fi ndings, biopsy technique and subsequent surgical histology of each patient. RESULTS: During the study period 60 769 women were invited for screening, o f whom 47 975 attended (attendance rate = 79%), Of these, 2330 (4.9%) were recalled for assessment and 749 (1.6%) underwent CB. A malignant diagnosis was obtained in 311 (42%), 211 invasive and 100 in situ lesions. LCIS was i dentified on CB in 13 (2%). LCIS was the only lesion identified in seven ca ses. All seven cases subsequently underwent surgical excision, Surgical his tology revealed a single case of LCIS and invasive lobular carcinoma, There were two cases of LCIS and DCIS one with a probable focus of invasive duct al carcinoma. In one case LCIS was identified in association with a radial scar. In three of the seven cases LCIS was the only abnormality on both CB and surgical biopsy. CONCLUSION: Our series shows that isolated LCIS on CB following mammographi c screening is an infrequent finding, and it may be associated with either an invasive cancer or DCIS. It is therefore advisable that when LCIS is ide ntified on CB, surgical excision of the mammographic abnormality should be performed. Decisions on management should be undertaken in a multidisciplin ary setting taking into account clinical and imaging findings. (C) 2001 The Royal College of Radiologists.