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Surgery Not Needed With All Abnormal Breast Lesions

Observation OK with concordant radiologic-pathologic correlations of ALH or LCIS at core biopsy

Surgery Not Needed With All Abnormal Breast Lesions

WEDNESDAY, July 31 (HealthDay News) -- Women with atypical lobular hyperplasia (ALH) or lobular carcinoma in situ (LCIS) biopsy findings can be safely observed when careful radiologic-pathologic correlation for concordance is established, according to research published online July 30 in Radiology.

Kristen A. Atkins, M.D., from the University of Virginia in Charlottesville, and colleagues searched a pathology database (2000 to 2010) and identified 50 cases from 49 women (mean age, 59 years) who had core biopsies yielding ALH or LCIS without any additional lesion that independently necessitated excision. All cases underwent surgical excision or had a minimum of two years of imaging follow-up. All biopsy-related images were compared with the histologic findings at core biopsy while blinded to subsequent follow-up information, and each core biopsy finding was designated as imaging-histologic concordant or discordant.

The researchers found that none of the 43 benign concordant core biopsy findings were upgraded at surgery (38 cases) or during extended follow-up (five cases). Five of the seven discordant biopsy findings were upgraded to ductal carcinoma in situ at surgery, while none of the two discordant cases were upgraded during follow-up.

"When careful radiologic-pathologic correlation is performed and concordance is achieved, women with ALH or LCIS at core biopsy can be observed," the authors write.

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