Is excisional biopsy indicated for patients with lobular neoplasia diagnosed on percutaneous core needle biopsy of the breast?

BackgroundThe value of excisional biopsy for patients with lobular neoplasia diagnosed by core needle breast biopsy is controversial.MethodsA retrospective analysis of all patients with lobular carcinoma in situ or atypical lobular hyperplasia on core needle biopsy.ResultsTwenty-five patients were identified. Twelve (48%) underwent excisional biopsy. None of the patients who had excisional biopsy were found to have ductal carcinoma in situ (DCIS) or invasive cancer. The mean follow-up was 66 months. Five patients (20%) developed DCIS or invasive cancer during follow-up. The rate of subsequent carcinoma among those undergoing excisional biopsy was 25%, and among those not undergoing excisional biopsy it was 15% (P = .57). Among patients who did not undergo excisional biopsy, none developed carcinoma within the same quadrant of the breast.ConclusionsExcisional biopsy for lobular neoplasia did not identify understaged carcinoma or alter the rate of subsequent carcinoma. The subsequent carcinoma risk is diffuse and bilateral; it does not correlate with the site at which lobular neoplasia was diagnosed.