Atypical lobular hyperplasia and lobular carcinoma in situ at core needle biopsy of thebreast: An incidental finding or are there characteristic imaging findings?

Abstract

Atypical lobular hyperplasia and classic-type lobular carcinoma in situ, collectively known as lobular neoplasia, are classically described as incidental findings found on breast core-needle biopsy without distinguishing imaging characteristics. The purpose of this study was to investigate concordant imaging findings of lobular neoplasia identified at core-needle biopsy after careful radiologic-pathologic correlation. The pathology database was searched from October 1, 2006 to October 1, 2013 for breast biopsies yielding lobular neoplasia not associated with a coexistent malignancy or other high risk lesion in the biopsy specimen. Of the 482 biopsies performed containing lobular neoplasia, 65 cases had lobular neoplasia as the highest risk lesion at core-needle biopsy. Of the 65 total cases in which lobular neoplasia was the highest risk lesion, 18 (28%) cases had concordant imaging correlates. 13 of 18 (72%) cases presented as calcifications on mammography and 5 of 18 (28%) presented on magnetic resonance imaging as a focus (n = 2) or non-mass enhancement (n = 3). With careful radiologic-pathologic correlation, mammographically detected calcifications and foci or non-mass enhancement on magnetic resonance imaging can be considered concordant imaging findings of lobular neoplasia after breast core-needle biopsy.