More about Breast Neoplasia (Lobular)
Breast Neoplasia describes a histological finding of unexpected new cell growth in the breast lobules. A discovery of lobular breast neoplasia is quite unexpected, and there is some difference in opinion as to whether or not lobular neoplasia presents a serious breast cancer threat requiring aggressive action.
Follow-up Surgical Excision or FSE
Among the management options for Lobular Breast Neoplasia is the follow-up surgical excision (FSE) of a given lesion or mass. This is not without controversy. Some experts point to the historical tendency to underestimate the malignancy of core needle samples (suggested to occur about 18% of the time), and thus it is prudent to remove additional breast tissue every time. Other factors might be increased risk factors such as a radial scar, papillary lesions, atypical ductal hyperplasia, and microcalcifications.
Lobular Breast Neoplasia is generally a favorable diagnosis
Lobular breast neoplasia is felt have a slightly greater tendency toward malignancy when compared to ductal neoplasia. But generally speaking the discovery of lobular neoplasia is felt to be a fortuitous diagnosis.
Lobular Breast Neoplasia is often considered a risk marker only
A majority of oncologists tend to view lobular breast neoplasia as a ‘risk marker‘ only and not a carcinoma, so surgical excision would seem unnecessary. Often an intitial finding of Lobular breast neoplasia does not suggest a definitive course of action, so a prudent physician might suggest a FSE a few months later, both to check for progress and to remove potentially malignant breast tissue. Consider your own anxiety level and accompanying factors.
This page barely has information on Lobular Neoplasia, so for further reading about this topic, I suggest you visit this page and this page as well! They both have some fantastic material.
Below are a couple common Q&A…
- What is the meaning of lobular breast neoplasia? When this occurs, there is an increase in the number of cells contained in the lobules, together with a change in their appearance and behavior.
- How is lobular neoplasia diagnosed? It can be difficult to diagnose because most women with lobular neoplasia have no symptoms. It is usually diagnosed after a biopsy is done on the breast for some other reason, such as an abnormal finding on a mammogram or a suspicious breast lump. These procedures may include fine need aspiration biopsy, core needle biopsy, incisional biopsy, or excisional biopsy.
- What are the treatment options for lobular breast neoplasia? Close monitoring (regular clinical exams, regular screening mammography, MRI, and monthly breast self-exams), hormone therapy medicines (such as tamoxifen, raloxifene, exemestane, and anastrozole have been shown to reduce breast cancer risk), and risk-reducing surgery (prophylactic mastectomy). Also, you may want to consider taking part in a clinical trial that is testing a new approach to reducing the risk of breast cancer.
- Cohen MA. Cancer Upgrade at Excisional Biopsy after Diagnosis of Atypical Lobular Hyperplasia or Lobular Carcinoma in Situ at Core-Needle Biopsy: Some Reasons Why. Radiology 2004; 231: 617-621.
- Elsheikh TM, Silverman JF. Follow-up Surgical Excision is Indicated when Breast Core Needle Biopsies Show Atypical Lobular Hyperplasia or Lobular Carcinoma in Situ. Am. J. Surg. Pathol. Volume 29, Number 4, April 2005.
- Lakhani SE. In Situ Lobular Neoplasia: time for an Awakening. Lancet 2003; 361: 96.
- Hwang, H., Sullivan, ME., Susnik, B. Lobular neoplasia. Diagnositic Histopathy. (July 2010) Volume 16, Issue 7, Pages 337-344