Pleomorphic lobular carcinoma in situ of the breast: Can the evidence guide practice?

Table 1 Risk that ductal carcinoma in situ or invasive carcinoma is found on subsequent surgical excision pathology following a core biopsy diagnosis of pleomorphic lobular carcinoma in situ

Ref.	No. of PLCIS cases	Diagnosis oncore biopsy	Surgical procedure	PLCIS alone on surgical specimen	Concurrent DCIS or invasive carcinoma on surgical specimen	Concurrent DCIS (%)	Concurrent invasive cancer (%)
Carder et al[4]	10	10 PLCIS	2 DB, 8 WLE	7	3 ILC	0	30
Chivukula et al[3]	12	12 PLCIS	1 DB, 1 WLE, 8 SMx, 1Mx, 1BMx	9	3 ILC	0	25
Fasola et al[30]	34	13 PLCIS 21 PLCIS + DCIS or IC	PLCIS: 11 WLE, 2 Mx PLCIS with DCIS or IC: 9 WLE, 12 Mx	4	9 DCIS 15 ILC 6 IDC	26	62
Morris et al[31]	17	3 PLCIS 7 PLCIS + DCIS 7 PLCIS + IC	17 WLE	3	3 DCIS 11 IC	18	65
Niell et al[32]	5	5 PLCIS	5 WLE	1	1 DCIS 2 ILC 1 IDC	20	60
Georgian-Smith et al[33]	5	5 PLCIS	5 WLE	3	2 IC	0	40
Lavoue et al[34]	10	10 PLCIS	10 WLE	7	3 ILC	0	30
Total	93	58 PLCIS 7 PLCIS + DCIS 7 PLCIS + IC 21 PLCIS + DCIS or IC		34	13 DCIS 26 ILC 7 IDC 13 IC	14	49

At initial assessment PLCIS is diagnosed on a core biopsy specimen, this table details the subsequent histology from a surgical resection of the area, demonstrating how many of the core biopsies are upgraded to invasive carcinoma or DCIS. PLCIS: Pleomorphic lobular carcinoma in situ; DCIS: Ductal carcinoma in situ; ILC: Invasive lobular carcinoma; IDC: Invasive ductal carcinoma; IC: Invasive carcinoma (with type not specified); DB: Diagnostic biopsy; WLE: Wide local excision; Mx: Mastectomy; SMx: Segmental mastectomy; BMx: Bilateral mastectomy.