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Lobular Carcinoma In Situ, Pleomorphic
Marion E. Scoggins, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            TERMINOLOGY

            • Abbreviations

              • Pleomorphic lobular carcinoma in situ (pLCIS)
            • Definitions

              • pLCIS: High nuclear grade LCIS, more aggressive subtype of lobular carcinoma in situ (LCIS)
              • Lobular neoplasia (LN): Spectrum of atypical lobular hyperplasia and LCIS

            IMAGING

            • General Features

              • Mammographic Findings

                • Ultrasonographic Findings

                  • MR Findings

                    • Image-Guided Biopsy

                      • Imaging Recommendations

                        DIFFERENTIAL DIAGNOSIS

                          PATHOLOGY

                          • General Features

                            • Microscopic Features

                              CLINICAL ISSUES

                              • Demographics

                                • Natural History & Prognosis

                                  • Treatment

                                    DIAGNOSTIC CHECKLIST

                                    • Image Interpretation Pearls

                                      Selected References

                                      1. Fasola CE et al: Characteristics and clinical outcomes of pleomorphic lobular carcinoma in situ of the breast. Breast J. 24(1):66-69, 2018
                                      2. Masannat YA et al: Pleomorphic LCIS what do we know? A UK multicenter audit of pleomorphic lobular carcinoma in situ. Breast. 38:120-124, 2018
                                      3. Savage JL et al: Pleomorphic lobular carcinoma in situ: Imaging features, upgrade rate, and clinical outcomes. AJR Am J Roentgenol. 1-6, 2018
                                      4. De Brot M et al: Pleomorphic lobular carcinoma in situ of the breast: a single institution experience with clinical follow-up and centralized pathology review. Breast Cancer Res Treat. 165(2):411-420, 2017
                                      5. Ginter PS et al: Current Concepts in Diagnosis, Molecular Features, and Management of Lobular Carcinoma In Situ of the Breast With a Discussion of Morphologic Variants. Arch Pathol Lab Med. 141(12):1668-1678, 2017
                                      6. Giuliano AE et al: Breast Cancer-Major changes in the American Joint Committee on Cancer eighth edition cancer staging manual. CA Cancer J Clin. 67(4):290-303, 2017
                                      7. Guo T et al: Pleomorphic lobular carcinoma in situ diagnosed by breast core biopsy: Clinicopathologic features and correlation with subsequent excision. Clin Breast Cancer. ePub, 2017
                                      8. Maxwell AJ et al: The radiological features, diagnosis and management of screen-detected lobular neoplasia of the breast: Findings from the Sloane Project. Breast. 27:109-15, 2016
                                      9. Wazir U et al: Pleomorphic lobular carcinoma in situ: Current evidence and a systemic review. Oncol Lett. 12(6):4863-4868, 2016
                                      10. Blanco LZ et al: Multinucleation is an objective feature useful in the diagnosis of pleomorphic lobular carcinoma in situ. Am J Clin Pathol. 144(5):722-6, 2015
                                      11. Chester R et al: UK national survey of management of breast lobular carcinoma in situ. Ann R Coll Surg Engl. 97(8):574-7, 2015
                                      12. Flanagan MR et al: Pleomorphic Lobular Carcinoma In Situ: Radiologic-Pathologic Features and Clinical Management. Ann Surg Oncol. 22(13):4263-9, 2015
                                      13. Lien HC et al: Frequent alterations of HER2 through mutation, amplification, or overexpression in pleomorphic lobular carcinoma of the breast. Breast Cancer Res Treat. 150(2):447-55, 2015
                                      14. Jorns J et al: Lobular neoplasia: morphology and management. Arch Pathol Lab Med. 138(10):1344-9, 2014
                                      15. Khoury T et al: Pleomorphic lobular carcinoma in situ of the breast: clinicopathological review of 47 cases. Histopathology. 64(7):981-93, 2014
                                      16. Meroni S et al: Underestimation rate of lobular intraepithelial neoplasia in vacuum-assisted breast biopsy. Eur Radiol. 24(7):1651-8, 2014
                                      17. Pieri A et al: Pleomorphic lobular carcinoma in situ of the breast: Can the evidence guide practice? World J Clin Oncol. 5(3):546-53, 2014
                                      18. Blair SL et al: Breast surgeon's survey: no consensus for surgical treatment of pleomorphic lobular carcinoma in situ. Breast J. 19(1):116-8, 2013
                                      19. Masannat YA et al: Challenges in the management of pleomorphic lobular carcinoma in situ of the breast. Breast. 22(2):194-6, 2013
                                      20. Shin SJ et al: Florid lobular carcinoma in situ: molecular profiling and comparison to classic lobular carcinoma in situ and pleomorphic lobular carcinoma in situ. Hum Pathol. 44(10):1998-2009, 2013
                                      21. Murray L et al: Pleomorphic lobular carcinoma in situ: treatment options for a new pathologic entity. Clin Breast Cancer. 12(1):76-9, 2012
                                      22. Chivukula M: Pleomorphic lobular carcinoma in situ: A divergent entity with emerging significance. Oncology (Williston Park). 25(4):358, 360, 362, 2011
                                      23. Downs-Kelly E et al: Clinical implications of margin involvement by pleomorphic lobular carcinoma in situ. Arch Pathol Lab Med. 135(6):737-43, 2011
                                      24. Hussain M et al: Management of lobular carcinoma in-situ and atypical lobular hyperplasia of the breast--a review. Eur J Surg Oncol. 37(4):279-89, 2011
                                      25. Brogi E et al: Lobular carcinoma, not only a classic. Breast J. 16 Suppl 1:S10-4, 2010
                                      26. Carder PJ et al: Screen-detected pleomorphic lobular carcinoma in situ (PLCIS): risk of concurrent invasive malignancy following a core biopsy diagnosis. Histopathology. 57(3):472-8, 2010
                                      27. Gao F et al: Clinical importance of histologic grading of lobular carcinoma in situ in breast core needle biopsy specimens: current issues and controversies. Am J Clin Pathol. 133(5):767-71, 2010
                                      28. Sullivan ME et al: Lobular carcinoma in situ variants in breast cores: potential for misdiagnosis, upgrade rates at surgical excision, and practical implications. Arch Pathol Lab Med. 134(7):1024-8, 2010
                                      29. Chen YY et al: Genetic and phenotypic characteristics of pleomorphic lobular carcinoma in situ of the breast. Am J Surg Pathol. 33(11):1683-94, 2009
                                      30. Chivukula M et al: Pleomorphic lobular carcinoma in situ (PLCIS) on breast core needle biopsies: clinical significance and immunoprofile. Am J Surg Pathol. 32(11):1721-6, 2008
                                      31. Lavoué V et al: Management of lobular neoplasia diagnosed by core needle biopsy: study of 52 biopsies with follow-up surgical excision. Breast. 16(5):533-9, 2007
                                      32. Fadare O et al: Lobular intraepithelial neoplasia [lobular carcinoma in situ] with comedo-type necrosis: A clinicopathologic study of 18 cases. Am J Surg Pathol. 30(11):1445-53, 2006
                                      33. Mahoney MC et al: Lobular neoplasia at 11-gauge vacuum-assisted stereotactic biopsy: correlation with surgical excisional biopsy and mammographic follow-up. AJR Am J Roentgenol. 187(4):949-54, 2006
                                      34. Elsheikh TM et al: Follow-up surgical excision is indicated when breast core needle biopsies show atypical lobular hyperplasia or lobular carcinoma in situ: a correlative study of 33 patients with review of the literature. Am J Surg Pathol. 29(4):534-43, 2005
                                      35. Sneige N et al: Clinical, histopathologic, and biologic features of pleomorphic lobular (ductal-lobular) carcinoma in situ of the breast: a report of 24 cases. Mod Pathol. 15(10):1044-50, 2002
                                      36. Georgian-Smith D et al: Calcifications of lobular carcinoma in situ of the breast: radiologic-pathologic correlation. AJR Am J Roentgenol. 176(5):1255-9, 2001
                                      37. Pacelli A et al: Outcome of atypical lobular hyperplasia and lobular carcinoma in situ diagnosed by core needle biopsy: clinical and surgical follow-up of 30 cases. Am J Clin Pathol. 116:591-2, 2001
                                      38. Sapino A et al: Mammographically detected in situ lobular carcinomas of the breast. Virchows Arch. 436(5):421-30, 2000
                                      39. Pleomorphic lobular carcinoma in situ
                                      40. Pleomorphic lobular carcinoma in situ
                                      41. The Diagnosis of Pleomorphic Lobular Carcinoma In Situ Warrants Complete Excision with Negative Margins
                                      42. Clinical and radiological presentation of pleomorphic lobular carcinoma in-situ and its association with invasive malignancy
                                      Related Anatomy
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                                      Related Differential Diagnoses
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                                      References
                                      Tables

                                      Tables

                                      KEY FACTS

                                      • Terminology

                                        • Imaging

                                          • Top Differential Diagnoses

                                            • Pathology

                                              • Clinical Issues

                                                TERMINOLOGY

                                                • Abbreviations

                                                  • Pleomorphic lobular carcinoma in situ (pLCIS)
                                                • Definitions

                                                  • pLCIS: High nuclear grade LCIS, more aggressive subtype of lobular carcinoma in situ (LCIS)
                                                  • Lobular neoplasia (LN): Spectrum of atypical lobular hyperplasia and LCIS

                                                IMAGING

                                                • General Features

                                                  • Mammographic Findings

                                                    • Ultrasonographic Findings

                                                      • MR Findings

                                                        • Image-Guided Biopsy

                                                          • Imaging Recommendations

                                                            DIFFERENTIAL DIAGNOSIS

                                                              PATHOLOGY

                                                              • General Features

                                                                • Microscopic Features

                                                                  CLINICAL ISSUES

                                                                  • Demographics

                                                                    • Natural History & Prognosis

                                                                      • Treatment

                                                                        DIAGNOSTIC CHECKLIST

                                                                        • Image Interpretation Pearls

                                                                          Selected References

                                                                          1. Fasola CE et al: Characteristics and clinical outcomes of pleomorphic lobular carcinoma in situ of the breast. Breast J. 24(1):66-69, 2018
                                                                          2. Masannat YA et al: Pleomorphic LCIS what do we know? A UK multicenter audit of pleomorphic lobular carcinoma in situ. Breast. 38:120-124, 2018
                                                                          3. Savage JL et al: Pleomorphic lobular carcinoma in situ: Imaging features, upgrade rate, and clinical outcomes. AJR Am J Roentgenol. 1-6, 2018
                                                                          4. De Brot M et al: Pleomorphic lobular carcinoma in situ of the breast: a single institution experience with clinical follow-up and centralized pathology review. Breast Cancer Res Treat. 165(2):411-420, 2017
                                                                          5. Ginter PS et al: Current Concepts in Diagnosis, Molecular Features, and Management of Lobular Carcinoma In Situ of the Breast With a Discussion of Morphologic Variants. Arch Pathol Lab Med. 141(12):1668-1678, 2017
                                                                          6. Giuliano AE et al: Breast Cancer-Major changes in the American Joint Committee on Cancer eighth edition cancer staging manual. CA Cancer J Clin. 67(4):290-303, 2017
                                                                          7. Guo T et al: Pleomorphic lobular carcinoma in situ diagnosed by breast core biopsy: Clinicopathologic features and correlation with subsequent excision. Clin Breast Cancer. ePub, 2017
                                                                          8. Maxwell AJ et al: The radiological features, diagnosis and management of screen-detected lobular neoplasia of the breast: Findings from the Sloane Project. Breast. 27:109-15, 2016
                                                                          9. Wazir U et al: Pleomorphic lobular carcinoma in situ: Current evidence and a systemic review. Oncol Lett. 12(6):4863-4868, 2016
                                                                          10. Blanco LZ et al: Multinucleation is an objective feature useful in the diagnosis of pleomorphic lobular carcinoma in situ. Am J Clin Pathol. 144(5):722-6, 2015
                                                                          11. Chester R et al: UK national survey of management of breast lobular carcinoma in situ. Ann R Coll Surg Engl. 97(8):574-7, 2015
                                                                          12. Flanagan MR et al: Pleomorphic Lobular Carcinoma In Situ: Radiologic-Pathologic Features and Clinical Management. Ann Surg Oncol. 22(13):4263-9, 2015
                                                                          13. Lien HC et al: Frequent alterations of HER2 through mutation, amplification, or overexpression in pleomorphic lobular carcinoma of the breast. Breast Cancer Res Treat. 150(2):447-55, 2015
                                                                          14. Jorns J et al: Lobular neoplasia: morphology and management. Arch Pathol Lab Med. 138(10):1344-9, 2014
                                                                          15. Khoury T et al: Pleomorphic lobular carcinoma in situ of the breast: clinicopathological review of 47 cases. Histopathology. 64(7):981-93, 2014
                                                                          16. Meroni S et al: Underestimation rate of lobular intraepithelial neoplasia in vacuum-assisted breast biopsy. Eur Radiol. 24(7):1651-8, 2014
                                                                          17. Pieri A et al: Pleomorphic lobular carcinoma in situ of the breast: Can the evidence guide practice? World J Clin Oncol. 5(3):546-53, 2014
                                                                          18. Blair SL et al: Breast surgeon's survey: no consensus for surgical treatment of pleomorphic lobular carcinoma in situ. Breast J. 19(1):116-8, 2013
                                                                          19. Masannat YA et al: Challenges in the management of pleomorphic lobular carcinoma in situ of the breast. Breast. 22(2):194-6, 2013
                                                                          20. Shin SJ et al: Florid lobular carcinoma in situ: molecular profiling and comparison to classic lobular carcinoma in situ and pleomorphic lobular carcinoma in situ. Hum Pathol. 44(10):1998-2009, 2013
                                                                          21. Murray L et al: Pleomorphic lobular carcinoma in situ: treatment options for a new pathologic entity. Clin Breast Cancer. 12(1):76-9, 2012
                                                                          22. Chivukula M: Pleomorphic lobular carcinoma in situ: A divergent entity with emerging significance. Oncology (Williston Park). 25(4):358, 360, 362, 2011
                                                                          23. Downs-Kelly E et al: Clinical implications of margin involvement by pleomorphic lobular carcinoma in situ. Arch Pathol Lab Med. 135(6):737-43, 2011
                                                                          24. Hussain M et al: Management of lobular carcinoma in-situ and atypical lobular hyperplasia of the breast--a review. Eur J Surg Oncol. 37(4):279-89, 2011
                                                                          25. Brogi E et al: Lobular carcinoma, not only a classic. Breast J. 16 Suppl 1:S10-4, 2010
                                                                          26. Carder PJ et al: Screen-detected pleomorphic lobular carcinoma in situ (PLCIS): risk of concurrent invasive malignancy following a core biopsy diagnosis. Histopathology. 57(3):472-8, 2010
                                                                          27. Gao F et al: Clinical importance of histologic grading of lobular carcinoma in situ in breast core needle biopsy specimens: current issues and controversies. Am J Clin Pathol. 133(5):767-71, 2010
                                                                          28. Sullivan ME et al: Lobular carcinoma in situ variants in breast cores: potential for misdiagnosis, upgrade rates at surgical excision, and practical implications. Arch Pathol Lab Med. 134(7):1024-8, 2010
                                                                          29. Chen YY et al: Genetic and phenotypic characteristics of pleomorphic lobular carcinoma in situ of the breast. Am J Surg Pathol. 33(11):1683-94, 2009
                                                                          30. Chivukula M et al: Pleomorphic lobular carcinoma in situ (PLCIS) on breast core needle biopsies: clinical significance and immunoprofile. Am J Surg Pathol. 32(11):1721-6, 2008
                                                                          31. Lavoué V et al: Management of lobular neoplasia diagnosed by core needle biopsy: study of 52 biopsies with follow-up surgical excision. Breast. 16(5):533-9, 2007
                                                                          32. Fadare O et al: Lobular intraepithelial neoplasia [lobular carcinoma in situ] with comedo-type necrosis: A clinicopathologic study of 18 cases. Am J Surg Pathol. 30(11):1445-53, 2006
                                                                          33. Mahoney MC et al: Lobular neoplasia at 11-gauge vacuum-assisted stereotactic biopsy: correlation with surgical excisional biopsy and mammographic follow-up. AJR Am J Roentgenol. 187(4):949-54, 2006
                                                                          34. Elsheikh TM et al: Follow-up surgical excision is indicated when breast core needle biopsies show atypical lobular hyperplasia or lobular carcinoma in situ: a correlative study of 33 patients with review of the literature. Am J Surg Pathol. 29(4):534-43, 2005
                                                                          35. Sneige N et al: Clinical, histopathologic, and biologic features of pleomorphic lobular (ductal-lobular) carcinoma in situ of the breast: a report of 24 cases. Mod Pathol. 15(10):1044-50, 2002
                                                                          36. Georgian-Smith D et al: Calcifications of lobular carcinoma in situ of the breast: radiologic-pathologic correlation. AJR Am J Roentgenol. 176(5):1255-9, 2001
                                                                          37. Pacelli A et al: Outcome of atypical lobular hyperplasia and lobular carcinoma in situ diagnosed by core needle biopsy: clinical and surgical follow-up of 30 cases. Am J Clin Pathol. 116:591-2, 2001
                                                                          38. Sapino A et al: Mammographically detected in situ lobular carcinomas of the breast. Virchows Arch. 436(5):421-30, 2000
                                                                          39. Pleomorphic lobular carcinoma in situ
                                                                          40. Pleomorphic lobular carcinoma in situ
                                                                          41. The Diagnosis of Pleomorphic Lobular Carcinoma In Situ Warrants Complete Excision with Negative Margins
                                                                          42. Clinical and radiological presentation of pleomorphic lobular carcinoma in-situ and its association with invasive malignancy