The florid subtype of lobular carcinoma in situ

Marker or precursor for invasive lobular carcinoma?

Sanjay P. Bagaria, Jaime Shamonki, Michelle Kinnaird, Partha S. Ray, Armando E. Giuliano

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

Background. Lobular carcinoma in situ (LCIS) is considered a risk factor-not a precursor-for both invasive lobular and ductal carcinoma. Florid LCIS (F-LCIS) is an architectural subtype of LCIS that does not express E-cadherin, yet has the histologic and often radiographic appearance of solid-type ductal carcinoma in situ (DCIS). Since DCIS is considered a precursor to invasive ductal carcinoma, should F-LCIS be considered a precursor to invasive lobular carcinoma (ILC)? Methods. Review of an institutional database identified cases of LCIS and solid-type DCIS diagnosed by excisional biopsy, segmentectomy, or mastectomy between 1991 and 2000 to determine the prevalence of associated invasive breast cancer. Archival specimens were evaluated for florid and nonflorid LCIS, nuclear grade of LCIS, and the presence and subtype of invasive breast cancer. Solid-type DCIS that lacked E-cadherin expression was classified as F-LCIS. Results. Of 210 consecutive specimens of LCIS examined, 171 had nonflorid LCIS (81%) and 39 had F-LCIS (19%). Nonflorid LCIS had a diffuse pattern, whereas F-LCIS appeared as discrete foci adjacent to ILC. An invasive component was identified with 87% of F-LCIS lesions versus 73% of nonflorid LCIS lesions (P = 0.064); this component was lobular in 100% of F-LCIS lesions versus 82% of nonflorid LCIS lesions, a significant difference (P = 0.0044) that persisted when the analysis was adjusted for nuclear grade (P = 0.0082). Conclusion. Its close spatial relationship to an invasive component and increased association with ILC suggest that F-LCIS may be a precursor for ILC.

Original languageEnglish (US)
Pages (from-to)1845-1851
Number of pages7
JournalAnnals of Surgical Oncology
Volume18
Issue number7
DOIs
StatePublished - Jul 2011

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Lobular Carcinoma
Carcinoma, Intraductal, Noninfiltrating
Ductal Carcinoma
Cadherins
Breast Carcinoma In Situ
Breast Neoplasms
Segmental Mastectomy
Mastectomy

ASJC Scopus subject areas

  • Surgery
  • Oncology

Cite this

The florid subtype of lobular carcinoma in situ : Marker or precursor for invasive lobular carcinoma? / Bagaria, Sanjay P.; Shamonki, Jaime; Kinnaird, Michelle; Ray, Partha S.; Giuliano, Armando E.

In: Annals of Surgical Oncology, Vol. 18, No. 7, 07.2011, p. 1845-1851.

Research output: Contribution to journalArticle

Bagaria, Sanjay P. ; Shamonki, Jaime ; Kinnaird, Michelle ; Ray, Partha S. ; Giuliano, Armando E. / The florid subtype of lobular carcinoma in situ : Marker or precursor for invasive lobular carcinoma?. In: Annals of Surgical Oncology. 2011 ; Vol. 18, No. 7. pp. 1845-1851.
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abstract = "Background. Lobular carcinoma in situ (LCIS) is considered a risk factor-not a precursor-for both invasive lobular and ductal carcinoma. Florid LCIS (F-LCIS) is an architectural subtype of LCIS that does not express E-cadherin, yet has the histologic and often radiographic appearance of solid-type ductal carcinoma in situ (DCIS). Since DCIS is considered a precursor to invasive ductal carcinoma, should F-LCIS be considered a precursor to invasive lobular carcinoma (ILC)? Methods. Review of an institutional database identified cases of LCIS and solid-type DCIS diagnosed by excisional biopsy, segmentectomy, or mastectomy between 1991 and 2000 to determine the prevalence of associated invasive breast cancer. Archival specimens were evaluated for florid and nonflorid LCIS, nuclear grade of LCIS, and the presence and subtype of invasive breast cancer. Solid-type DCIS that lacked E-cadherin expression was classified as F-LCIS. Results. Of 210 consecutive specimens of LCIS examined, 171 had nonflorid LCIS (81{\%}) and 39 had F-LCIS (19{\%}). Nonflorid LCIS had a diffuse pattern, whereas F-LCIS appeared as discrete foci adjacent to ILC. An invasive component was identified with 87{\%} of F-LCIS lesions versus 73{\%} of nonflorid LCIS lesions (P = 0.064); this component was lobular in 100{\%} of F-LCIS lesions versus 82{\%} of nonflorid LCIS lesions, a significant difference (P = 0.0044) that persisted when the analysis was adjusted for nuclear grade (P = 0.0082). Conclusion. Its close spatial relationship to an invasive component and increased association with ILC suggest that F-LCIS may be a precursor for ILC.",
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AU - Ray, Partha S.

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AB - Background. Lobular carcinoma in situ (LCIS) is considered a risk factor-not a precursor-for both invasive lobular and ductal carcinoma. Florid LCIS (F-LCIS) is an architectural subtype of LCIS that does not express E-cadherin, yet has the histologic and often radiographic appearance of solid-type ductal carcinoma in situ (DCIS). Since DCIS is considered a precursor to invasive ductal carcinoma, should F-LCIS be considered a precursor to invasive lobular carcinoma (ILC)? Methods. Review of an institutional database identified cases of LCIS and solid-type DCIS diagnosed by excisional biopsy, segmentectomy, or mastectomy between 1991 and 2000 to determine the prevalence of associated invasive breast cancer. Archival specimens were evaluated for florid and nonflorid LCIS, nuclear grade of LCIS, and the presence and subtype of invasive breast cancer. Solid-type DCIS that lacked E-cadherin expression was classified as F-LCIS. Results. Of 210 consecutive specimens of LCIS examined, 171 had nonflorid LCIS (81%) and 39 had F-LCIS (19%). Nonflorid LCIS had a diffuse pattern, whereas F-LCIS appeared as discrete foci adjacent to ILC. An invasive component was identified with 87% of F-LCIS lesions versus 73% of nonflorid LCIS lesions (P = 0.064); this component was lobular in 100% of F-LCIS lesions versus 82% of nonflorid LCIS lesions, a significant difference (P = 0.0044) that persisted when the analysis was adjusted for nuclear grade (P = 0.0082). Conclusion. Its close spatial relationship to an invasive component and increased association with ILC suggest that F-LCIS may be a precursor for ILC.

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