Some traits of lobular in-situ neoplasia can predict the risk of developing invasive breast cancer

In this study researchers investigated which traits of lobular in-situ neoplasia (LN) are likely to predict upgrade to invasive breast cancer.

LN is the presence of abnormal cells in the lobules (milk-producing glands) of the breast. LN includes 2 conditions which are considered to increase the risk of developing breast cancer (precancerous) such as atypical lobular hyperplasia (ALH) and lobular carcinoma in situ (LCIS). Typically, LN is detected using a core needle biopsy (CNB), a test where the doctor uses a very fine needle to sample suspicious breast tissue. Breast tissue might be considered suspicious because of a lump or because of unusual findings after imaging, such as a mammogram (x-ray of the breast) or ultrasound (a test that uses sound waves to make pictures of the tissues of the body). LN is not necessarily considered cancer. However, some LNs could eventually develop into cancer and these patients would benefit from excision (surgical removal). After excision and a pathological examination, the doctor can help identify other precancerous breast lesions such as atypical ductal hyperplasia or ADH (the presence of abnormal cells in the milk ducts, the tubes that connect the lobules to the nipple) or even detect the presence of invasive breast cancer. It is important to identify the traits that indicate LN could eventually develop into invasive breast cancer in order to provide the best treatment options for these patients.

106 patients who had LN identified by CNB were included in this study. 73 of these patients had ALH and 33 had LCIS. Of all patients, 76 of all patients had LN alone, and 30 patients had LN plus ADH. 88% of patients had surgery to remove the suspicious breast tissue. 7.5% of all patients with LN, with or without ADH on CNB, were found to have invasive breast cancer after the pathological examination. When the results of surgery plus CNB revealed LCIS and ADH, 29% of patients were found to have invasive cancers. The presence of LCIS alone, however, predicted invasive cancer in only 5% of patients. High-risk patients, who had prior personal or family history of breast cancer, were more likely to have invasive cancer upon surgery. Finally, having more than 4 LN groups of abnormal cells (called foci), was associated with a higher risk of a patient developing invasive breast cancer than when 3 or fewer foci were present.

In summary, few LN patients develop invasive breast cancer, but individual risk factors can affect these odds.

Fairly few patients were used in this study, which makes it difficult to generalize the results to a broad population. Furthermore, the authors did not conduct statistics on many of their data, which makes it difficult to assess whether different groups of patients are really different or similar to each other.