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Annals of Surgical Oncology

, Volume 18, Issue 7, pp 1845–1851 | Cite as

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
Breast Oncology

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.

Keywords

Invasive Breast Cancer Invasive Ductal Carcinoma Core Needle Biopsy Invasive Lobular Carcinoma Nuclear Grade 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgment

Supported by funding from the Margie and Robert E. Petersen Foundation (Los Angeles, CA), QVC and the Fashion Footwear Association of New York Charitable Foundation (New York, NY), Mrs. Lois Rosen (Los Angeles, CA), the Associates for Breast and Prostate Cancer Studies (Santa Monica, CA), Maria Lucia and Fernando Diez Barroso (Beverly Hills, CA), the Ruth and Martin H. Weil Fund (Los Angeles, CA), the Lance Armstrong Foundation (Austin, TX), the John Wayne Cancer Foundation (Newport Beach, CA), the Wrather Family Foundation (Los Alamos, CA), the Samueli Foundation (Corona Del Mar, CA) [Dr. Bagaria], and the Harold H. McAlister Charitable Foundation (Los Angeles, CA) [Dr. Ray].

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Copyright information

© Society of Surgical Oncology 2011

Authors and Affiliations

  • Sanjay P. Bagaria
    • 1
    • 3
  • Jaime Shamonki
    • 2
  • Michelle Kinnaird
    • 2
  • Partha S. Ray
    • 1
    • 4
  • Armando E. Giuliano
    • 1
  1. 1.Department of Surgical OncologyJohn Wayne Cancer Institute at Saint John’s Health CenterSanta MonicaUSA
  2. 2.Department of PathologySaint John’s Health CenterSanta MonicaUSA
  3. 3.Mayo ClinicJacksonvilleUSA
  4. 4.University of IllinoisUrbana-ChampaignUSA

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