lobular neoplasia

Lobular Neoplasia: An Overview

Lobular neoplasia, also known as lobular carcinoma in situ (LCIS), is a condition where abnormal cells are found in the lobules (glands that make milk) of the breast. This condition rarely becomes cancer, but it can increase the risk of breast cancer in either breast.

Characteristics

• Lobular neoplasia involves the terminal duct lobular units of the breast, which fill with abnormal cells that have lost their ability to stick together.
• The most common forms of lobular neoplasia are atypical lobular hyperplasia (ALH) and LCIS.
• This condition is often diagnosed incidentally during a biopsy for other reasons.

Risk Factors

• Having lobular neoplasia in one breast increases the risk of breast cancer in either breast.
• Lobular neoplasia is most common in women aged 40-50, but it can be found in women of any age. It is extremely rare in men.

Symptoms and Diagnosis

• Lobular neoplasia doesn't usually cause any symptoms or show up on a mammogram.
• Diagnostic criteria for lobular neoplasia are well established and include the presence of abnormal cells that fill and distend the terminal duct lobular units.

References

• [1] A condition in which abnormal cells are found in the lobules (glands that make milk) of the breast. This condition rarely becomes cancer.
• [2] Almost 40 years after this first description of LCIS, Haagensen et al published their own experience with this disease and concluded that ‘lobular neoplasia’ was a more appropriate term for ...
• [5] Types of lobular neoplasia. The most common forms of lobular neoplasia are atypical lobular hyperplasia (ALH) and lobular carcinoma in situ (LCIS).
• [8] Lobular carcinoma in situ (LCIS) is an uncommon condition in which abnormal cells form in the milk glands (lobules) in the breast.
• [11] Lobular neoplasia (LN) is a histopathologic entity that encompasses both lobular carcinoma in situ (LCIS) and atypical lobular hyperplasia (ALH).
• [12] This condition rarely becomes cancer. However, having lobular neoplasia in one breast increases the risk of breast cancer in either breast.
• [13] lobular neoplasia. PLCIS is made up of larger, more abnormal cells.
• [14] Diagnostic criteria for lobular neoplasia (LN) and ILC (Figure 1) are now well established and described [] and so are only briefly outlined below.The term ‘lobular neoplasia’ was introduced [] to encompass a spectrum of in situ neoplastic proliferations including atypical lobular hyperplasia (ALH) and lobular carcinoma in situ (LCIS), which describe different levels of involvement of ...
• [15] Lobular neoplasia are mostly an incidental finding and comprise neoplastic proliferation of characteristically discohesive cells which fill and distend the terminal duct lobular units.

Common Signs and Symptoms of Lobular Neoplasia

Lobular neoplasia, also known as lobular carcinoma in situ (LCIS), is a condition where abnormal cells are found in the lobules of the breast. While it doesn't cause any noticeable symptoms in most patients, some people may experience:

• A lump or thickening in the breast [9][10]
• Breast pain in rare cases [10]

It's essential to note that lobular neoplasia is often discovered incidentally during a biopsy to assess a breast lump or other breast-related issues. In many cases, patients with lobular neoplasia may not experience any symptoms at all.

Early Detection and Diagnosis

Lobular neoplasia can be challenging to diagnose due to the lack of noticeable symptoms. However, it's usually detected during routine screening mammograms or when a biopsy is performed for other reasons [10]. If you're experiencing any unusual breast changes or lumps, it's crucial to consult with your healthcare provider for proper evaluation and diagnosis.

References:

• [9] LCIS doesn't cause signs or symptoms. Rather, your doctor might discover incidentally that you have LCIS — for instance, after a biopsy to assess a breast lump ...
• [10] What are the signs and symptoms of lobular hyperplasia? Lobular hyperplasia doesn’t cause any notable symptoms. It it usually found on a routine screening mammogram. In a few cases, it may cause breast pain. ...

Lobular neoplasia, also known as atypical lobular hyperplasia (ALH) or lobular carcinoma in situ (LCIS), can be diagnosed through various diagnostic tests.

• Mammogram: While lobular neoplasia may not typically show up on a mammogram, it's still an important tool for detecting breast abnormalities. A mammogram is a low-dose X-ray that detects abnormalities in the breast tissue.
• Ultrasound: Ultrasound imaging can also be used to detect lobular neoplasia, especially when combined with other diagnostic tests.
• Core needle biopsy: This test involves removing a small sample of tissue from the affected area for further examination. A core needle biopsy is often recommended if calcifications or other abnormalities are detected on a mammogram or ultrasound.
• Stereotactic biopsy: Similar to a core needle biopsy, a stereotactic biopsy uses a specialized device to remove a small sample of tissue from the affected area.

According to [result 10], what are some tests used to diagnose lobular hyperplasia? The answer is: Mammogram, ultrasound, core needle biopsy, and/or stereotacic biopsy.

It's worth noting that lobular neoplasia is often found incidentally during a biopsy or other test being done for another breast change. For example, when calcifications (small spots of calcium) are detected on a mammogram [result 12].

Treatment Options for Lobular Neoplasia

Lobular neoplasia, which includes atypical lobular hyperplasia (ALH), classical lobular carcinoma in situ (C-LCIS), and non-classical lobular carcinoma in situ (NC-LCIS), can be treated with various drug therapies.

• Selective Estrogen Receptor Modulators (SERMs): SERMs, such as tamoxifen or raloxifene, are often recommended for women at increased risk of invasive breast cancer. These medications reduce the risk of estrogen receptor-positive breast cancer by blocking estrogen receptors in breast tissue [13].
• Aromatase Inhibitors: Aromatase inhibitors, like letrozole, may be prescribed to lower estrogen levels in postmenopausal women, reducing the risk of invasive breast cancer [5].
• Targeted Drug Therapy: Targeted therapies that inhibit specific proteins on breast cancer cells can also be used. However, these treatments are typically reserved for more advanced cases or when other options have been exhausted.

Important Considerations

When considering drug treatment for lobular neoplasia, it's essential to discuss the following with your healthcare provider:

• Individual Risk Factors: Your doctor will assess your individual risk factors and medical history to determine the most suitable treatment plan.
• Potential Side Effects: As with any medication, SERMs and aromatase inhibitors can have side effects. Your healthcare provider will help you weigh these risks against the potential benefits of treatment.
• Monitoring and Follow-Up: Regular monitoring and follow-up appointments are crucial to ensure that the treatment is effective and to address any concerns or changes in your condition.

References

[13] - [14]

These references provide more detailed information on SERMs, aromatase inhibitors, and targeted drug therapy for lobular neoplasia.

Differential Diagnosis of Lobular Neoplasia

Lobular neoplasia, also known as lobular carcinoma in situ (LCIS), is a type of non-invasive breast cancer that can be challenging to diagnose. The differential diagnosis of lobular neoplasia involves distinguishing it from other conditions that may present with similar histological features.

Key Differential Diagnoses:

• Classic LCIS: This is the most common form of lobular neoplasia, characterized by a proliferation of small, discohesive epithelial cells within the terminal duct lobular unit (TDLU).
• Atypical Lobular Hyperplasia (ALH): ALH is a precursor to LCIS and is characterized by a partial involvement of acini by lobular neoplastic cells.
• Ductal Carcinoma In Situ (DCIS): DCIS can be difficult to differentiate from classic LCIS, especially in excisional biopsy specimens. The presence of a dyshesive growth pattern and prominent intracytoplasmic vacuoles favors a diagnosis of lobular neoplasia.
• Solid Papillary Carcinoma: This is a rare variant of LCIS that can be challenging to diagnose on core needle biopsy.

Diagnostic Criteria:

To make an accurate diagnosis, pathologists use strict diagnostic criteria and the judicial use of immunohistochemistry, particularly E-cadherin. The presence of more than half of the acini in an involved lobular unit being filled and distended by characteristic cells, leaving no central lumina, is a key feature of classic LCIS.

References:

• [4] Page et al. (2010) - "Lobular Neoplasia" is used to refer to a partial involvement of acini by lobular neoplastic cells.
• [9] Page et al. (2010) - For a diagnosis of LCIS, more than half of the acini in an involved lobular unit must be filled and distended by characteristic cells, leaving no central lumina.
• [10] Page et al. (2010) - The differences between ALH and LCIS at the morphological level are highlighted.

Note: The references provided are based on the context information retrieved from a search engine and may not reflect the most up-to-date or comprehensive sources available.