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Lobular Neoplasia 

 Lobular neoplasia is a condition in which the breast’s milk-producing glands (lobules) are found to contain abnormal cells. Rarely does the condition become cancerous; however; the risk of breast cancer in either breast is increased by having lobular neoplasia. 

Types of Lobular Neoplasia 

  • Atypical lobular hyperplasia (ALH) 
  • Classical lobular carcinoma in situ (LCIS) 
  • Pleomorphic lobular carcinoma in situ (PLCIS) 

By ‘in situ’ it means that the changes only develop in the breast lobules and do not affect the surrounding breast tissue. 

Lobular neoplasia is more prevalent in women between the ages of 40 and 50 years old but it can be found in women of any age. 

Diagnosis of Lobular Neoplasia 

Lobular neoplasia does not normally present any symptoms or show up on a mammogram and is typically discovered during a biopsy or other test for another breast condition. For instance, when calcifications (tiny calcium spots) are found during a mammography. 

If presence of lobular neoplasia is detected, the specialist may recommend extracting tissue from the affected area.  This is done to look for cancerous cells in this area of the breast. 

The following procedures may be used in the diagnosis of lobular neoplasia: 

  • A mammogram or ultrasound: Used to help identify the afflicted area. 
  • Core biopsy: The doctor uses a hollow needle to take a sample of tissue to be examined under a microscope. It is done under local anesthesia. 
  • Vacuum assisted excision biopsy: Under local anesthesia, a sample of tissue is taken with a hollow probe attached to a vacuum for microscopy analysis. 
  • Excision biopsy: The tissue of a breast sample is extracted and examined under a microscope. The procedure can be conducted under local or general anesthesia. 

Treatment for Lobular Neoplasia 

Lobular neoplasia treatment is dependent on the type of the condition. 

  • Pleomorphic lobular carcinoma in situ (PLCIS)  

For PLCIS, the doctor may recommend surgery to remove the region with a margin (border) of healthy breast tissue if the biopsy detects PLCIS. This is necessary due to higher risk of breast cancer. The surgery will help the doctor see if there are any cancer cells in the tissue, and if all the PLCIS has been removed. 

  • ALH and classical lobular carcinoma in situ (LCIS) 

The patient will not usually need treatment for ALH and classical LCIS, but the doctor may discuss treatment options with the patient based on current guidelines and her individual evaluation. 

  • Hormone therapy 

Tamoxifen, a hormone therapy drug used to treat breast cancer, has been demonstrated in studies to lower the chance of breast cancer developing in women with lobular neoplasia. 

Lobular Neoplasia and Breast Cancer Risk 

Most women with ALH or traditional LCIS diagnoses have a minimal risk of developing breast cancer. However, compared to the general population, there is a marginally increased risk of either breast getting breast cancer.  

Compared to women with ALH or traditional LCIS, those with PLCIS are more likely to develop breast cancer. 

Follow-up 

The doctor will normally recommend that the patient have yearly follow-up mammograms for up to 5 years 

 

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