Yazan A Masannat1, Ehab Husain2, Rebecca Roylance3, Steven D Heys4, Pauline J Carder5, Hiam Ali6, Yasmine Maurice7, Sarah E Pinder8, Elinor Sawyer9, Abeer M Shaaban10. 1. Aberdeen Royal Infirmary, Foresterhill, Aberdeen, AB25 2ZN, Scotland, UK; School of Medicine, Medical Sciences and Nutrition, University of Aberdeen Polwarth Building, University Medical Buildings, Forresterhill, Aberdeen, AB25 2ZD, Scotland, UK. Electronic address: Yazan.masannat@nhs.net. 2. Aberdeen Royal Infirmary, Foresterhill, Aberdeen, AB25 2ZN, Scotland, UK; School of Medicine, Medical Sciences and Nutrition, University of Aberdeen Polwarth Building, University Medical Buildings, Forresterhill, Aberdeen, AB25 2ZD, Scotland, UK. Electronic address: e.husain@nhs.net. 3. Department of Oncology, University College Hospital NHS Foundation Trust and NIHR University College London Hospitals Biomedical Research Centre, 250 Euston Road, London, NW1 2PG, England, UK. Electronic address: r.roylance@ucl.ac.uk. 4. Aberdeen Royal Infirmary, Foresterhill, Aberdeen, AB25 2ZN, Scotland, UK; School of Medicine, Medical Sciences and Nutrition, University of Aberdeen Polwarth Building, University Medical Buildings, Forresterhill, Aberdeen, AB25 2ZD, Scotland, UK. Electronic address: s.d.heys@abdn.ac.uk. 5. Bradford Teaching Hospitals NHS Trust, Duckworth Lane, Bradford, BD9 6RJ, England, UK. Electronic address: Pauline.carder@bthft.nhs.uk. 6. Royal Stoke University Hospital, Newcastle Road, Stoke-on-Trent, ST4 6QG, England, UK. Electronic address: Hiam.ali1@nhs.net. 7. Wirral University Teaching Hospital, Liverpool, England, UK. Electronic address: yasmine.maurice@nhs.net. 8. King's College London, Cancer Studies, 9th Floor, Innovation Hub, Comprehensive Cancer Centre, Guy's Hospital, Great Maze Pond, London, SE1 9RT, England, UK. Electronic address: sarah.pinder@kcl.ac.uk. 9. King's College London, Cancer Studies, 9th Floor, Innovation Hub, Comprehensive Cancer Centre, Guy's Hospital, Great Maze Pond, London, SE1 9RT, England, UK. Electronic address: Elinor.sawyer@kcl.ac.uk. 10. University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital Birmingham, Mindelsohn Way, Edgbaston, Birmingham, B15 2GW, UK. Electronic address: Abeer.shaaban@uhb.nhs.uk.
Abstract
AIMS: Pleomorphic lobular carcinoma in situ (PLCIS) is a relatively newly described pathological lesion that is distinguished from classical LCIS by its large pleomorphic nuclei. The lesion is uncommon and its appropriate management has been debated. The aim of this study is to review data from a large series of PLCIS to examine its natural history in order to guide management plans. MATERIALS AND METHODS: Comprehensive pathology data were collected from two cohorts; one from a UK multicentre audit and the other a series of PLCIS cases identified from within the GLACIER study cohort. 179 cases were identified of whom 176 had enough data for analysis. RESULTS: Out of these 176 cases, 130 had invasive disease associated with PLCIS, the majority being of lobular type (classical and/or pleomorphic). A high incidence of histological grade 2 and 3 invasive cancers was noted with a predominance of ER positive and HER-2 negative malignancy. When PLCIS was the most significant finding on diagnostic biopsy the upgrade to invasive disease on excision was 31.8%, which is higher than pooled data for classical LCIS and DCIS. CONCLUSION: The older age at presentation, high grade of upgrade to invasive cancer, common association with higher grade tumours suggest that PLCIS is an aggressive form of insitu disease. These findings support the view that PLCIS is a more aggressive form of lobular in situ neoplasia and supports the tendency to treat akin to DCIS.
AIMS: Pleomorphic lobular carcinoma in situ (PLCIS) is a relatively newly described pathological lesion that is distinguished from classical LCIS by its large pleomorphic nuclei. The lesion is uncommon and its appropriate management has been debated. The aim of this study is to review data from a large series of PLCIS to examine its natural history in order to guide management plans. MATERIALS AND METHODS: Comprehensive pathology data were collected from two cohorts; one from a UK multicentre audit and the other a series of PLCIS cases identified from within the GLACIER study cohort. 179 cases were identified of whom 176 had enough data for analysis. RESULTS: Out of these 176 cases, 130 had invasive disease associated with PLCIS, the majority being of lobular type (classical and/or pleomorphic). A high incidence of histological grade 2 and 3 invasive cancers was noted with a predominance of ER positive and HER-2 negative malignancy. When PLCIS was the most significant finding on diagnostic biopsy the upgrade to invasive disease on excision was 31.8%, which is higher than pooled data for classical LCIS and DCIS. CONCLUSION: The older age at presentation, high grade of upgrade to invasive cancer, common association with higher grade tumours suggest that PLCIS is an aggressive form of insitu disease. These findings support the view that PLCIS is a more aggressive form of lobular in situ neoplasia and supports the tendency to treat akin to DCIS.
Authors: M Gabriela Kuba; Melissa P Murray; Kristen Coffey; Catarina Calle; Monica Morrow; Edi Brogi Journal: Mod Pathol Date: 2021-04-06 Impact factor: 7.842