Lobular Carcinoma in Situ: Diagnostic Criteria and Molecular Correlates

Overview

Journal Mod Pathol

Specialty Pathology

Date 2020 Oct 7

PMID 33024303

Citations 7

Authors

Anna Sokolova

Sunil R Lakhani

Affiliations

Soon will be listed here.

Abstract

Lobular neoplasia (LN) is an atypical proliferation of small, dyscohesive epithelial cells within the terminal duct lobular unit (TDLU), with or without pagetoid extension and encompasses both lobular carcinoma in situ (LCIS) and atypical lobular hyperplasia (ALH). LN is a non-obligate precursor of invasive breast carcinoma and the diagnosis of LN confers an increased risk of invasive carcinoma development, compared to the general population. Diagnostic challenges arise in the accurate classification of LCIS into classic, pleomorphic and florid subtypes, in distinguishing between LCIS and ductal carcinoma in situ (DCIS) and in the appropriate use and interpretation of E-cadherin immunohistochemistry. Due to the paucity of robust data on the natural history of LCIS, and hence its clinical significance, the management is often pragmatic rather than entirely evidence-based and requires a multidisciplinary approach. In this review, we discuss the clinicopathologic and molecular features of LCIS and address the key challenges that arise in the diagnosis and management of LCIS.

Citing Articles

Unraveling complexity and leveraging opportunities in uncommon breast cancer subtypes.

Pareja F, Bhargava R, Borges V, Brogi E, Canas Marques R, Cardoso F NPJ Breast Cancer. 2025; 11(1):6.

PMID: 39856067 PMC: 11760369. DOI: 10.1038/s41523-025-00719-w.

Small intestinal metastasis from primary breast cancer: a case report and review of literature.

Shen F, Wang S, Yu S, Jiang Y Front Immunol. 2024; 15():1475018.

PMID: 39697330 PMC: 11653178. DOI: 10.3389/fimmu.2024.1475018.

The Genomic and Biologic Landscapes of Breast Cancer and Racial Differences.

Galappaththi S, Smith K, Alsatari E, Hunter R, Dyess D, Turbat-Herrera E Int J Mol Sci. 2024; 25(23).

PMID: 39684874 PMC: 11642636. DOI: 10.3390/ijms252313165.

E-cadherin staining in the diagnosis of lobular versus ductal neoplasms of the breast: the emperor has no clothes.

Taha S, Boulos F Histopathology. 2024; 86(3):327-340.

PMID: 39138705 PMC: 11707503. DOI: 10.1111/his.15295.

The SEMA3F-NRP1/NRP2 axis is a key factor in the acquisition of invasive traits in in situ breast ductal carcinoma.

Moragas N, Fernandez-Nogueira P, Recalde-Percaz L, Inman J, Lopez-Plana A, Bergholtz H Breast Cancer Res. 2024; 26(1):122.

PMID: 39138514 PMC: 11320849. DOI: 10.1186/s13058-024-01871-0.

References

Page D, Kidd Jr T, Dupont W, Simpson J, Rogers L . Lobular neoplasia of the breast: higher risk for subsequent invasive cancer predicted by more extensive disease. Hum Pathol. 1991; 22(12):1232-9. DOI: 10.1016/0046-8177(91)90105-x. View

FOOTE F, STEWART F . Lobular carcinoma in situ: A rare form of mammary cancer. Am J Pathol. 2009; 17(4):491-496.3. PMC: 1965212. DOI: 10.3322/canjclin.32.4.234. View

Page D, Vander Zwaag R, Rogers L, Williams L, Walker W, Hartmann W . Relation between component parts of fibrocystic disease complex and breast cancer. J Natl Cancer Inst. 1978; 61(4):1055-63. View

HAAGENSEN C, Lane N, Lattes R, Bodian C . Lobular neoplasia (so-called lobular carcinoma in situ) of the breast. Cancer. 1978; 42(2):737-69. DOI: 10.1002/1097-0142(197808)42:2<737::aid-cncr2820420247>3.0.co;2-t. View

Rosen P, Kosloff C, Lieberman P, ADAIR F, Braun Jr D . Lobular carcinoma in situ of the breast. Detailed analysis of 99 patients with average follow-up of 24 years. Am J Surg Pathol. 1978; 2(3):225-51. DOI: 10.1097/00000478-197809000-00001. View

Beute B, Kalisher L, HUTTER R . Lobular carcinoma in situ of the breast: clinical, pathologic, and mammographic features. AJR Am J Roentgenol. 1991; 157(2):257-65. DOI: 10.2214/ajr.157.2.1853802. View

Shin S, Lal A, De Vries S, Suzuki J, Roy R, Hwang E . Florid lobular carcinoma in situ: molecular profiling and comparison to classic lobular carcinoma in situ and pleomorphic lobular carcinoma in situ. Hum Pathol. 2013; 44(10):1998-2009. DOI: 10.1016/j.humpath.2013.04.004. View

Maxwell A, Clements K, Dodwell D, Evans A, Francis A, Hussain M . The radiological features, diagnosis and management of screen-detected lobular neoplasia of the breast: Findings from the Sloane Project. Breast. 2016; 27:109-15. DOI: 10.1016/j.breast.2016.03.004. View

Fasola C, Chen J, Jensen K, Allison K, Horst K . Characteristics and clinical outcomes of pleomorphic lobular carcinoma in situ of the breast. Breast J. 2017; 24(1):66-69. DOI: 10.1111/tbj.12843. View

10.

Flanagan M, Rendi M, Calhoun K, Anderson B, Javid S . Pleomorphic Lobular Carcinoma In Situ: Radiologic-Pathologic Features and Clinical Management. Ann Surg Oncol. 2015; 22(13):4263-9. PMC: 4609251. DOI: 10.1245/s10434-015-4552-x. View

11.

Chen Y, Hwang E, Roy R, DeVries S, Anderson J, Wa C . Genetic and phenotypic characteristics of pleomorphic lobular carcinoma in situ of the breast. Am J Surg Pathol. 2009; 33(11):1683-94. PMC: 2783988. DOI: 10.1097/PAS.0b013e3181b18a89. View

12.

Shamir E, Chen Y, Chu T, Pekmezci M, Rabban J, Krings G . 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. Am J Surg Pathol. 2018; 43(3):399-408. DOI: 10.1097/PAS.0000000000001191. View

13.

Rosen P, Senie R, Schottenfeld D, Ashikari R . Noninvasive breast carcinoma: frequency of unsuspected invasion and implications for treatment. Ann Surg. 1979; 189(3):377-82. PMC: 1397090. DOI: 10.1097/00000658-197903000-00021. View

14.

Rosen P, Braun Jr D, Lyngholm B, URBAN J, Kinne D . Lobular carcinoma in situ of the breast: preliminary results of treatment by ipsilateral mastectomy and contralateral breast biopsy. Cancer. 1981; 47(4):813-9. DOI: 10.1002/1097-0142(19810215)47:4<813::aid-cncr2820470431>3.0.co;2-j. View

15.

URBAN J . Bilaterality of cancer of the breast. Biopsy of the opposite breast. Cancer. 1967; 20(11):1867-70. DOI: 10.1002/1097-0142(196711)20:11<1867::aid-cncr2820201111>3.0.co;2-#. View

16.

Zurrida S, Bartoli C, Galimberti V, Raselli R, Barletta L . Interpretation of the risk associated with the unexpected finding of lobular carcinoma in situ. Ann Surg Oncol. 1996; 3(1):57-61. DOI: 10.1007/BF02409052. View

17.

Bodian C, Perzin K, Lattes R . Lobular neoplasia. Long term risk of breast cancer and relation to other factors. Cancer. 1996; 78(5):1024-34. DOI: 10.1002/(SICI)1097-0142(19960901)78:5<1024::AID-CNCR12>3.0.CO;2-4. View

18.

Habel L, Moe R, Daling J, Holte S, Rossing M, Weiss N . Risk of contralateral breast cancer among women with carcinoma in situ of the breast. Ann Surg. 1997; 225(1):69-75. PMC: 1190608. DOI: 10.1097/00000658-199701000-00008. View

19.

Warnberg F, Yuen J, Holmberg L . Risk of subsequent invasive breast cancer after breast carcinoma in situ. Lancet. 2000; 355(9205):724-5. DOI: 10.1016/S0140-6736(99)03703-4. View

20.

Franceschi S, Levi F, La Vecchia C, Randimbison L, Te V . Second cancers following in situ carcinoma of the breast. Int J Cancer. 1998; 77(3):392-5. DOI: 10.1002/(sici)1097-0215(19980729)77:3<392::aid-ijc14>3.0.co;2-a. View