[Lobular neoplasia].

Area of Science:

• Pathology
• Oncology
• Radiology

Background:

• The understanding and management of lobular lesions have significantly evolved over the past three decades.
• Current knowledge gaps persist, potentially leading to suboptimal patient care for lobular neoplasia.
• Histopathological reclassification of lobular changes is crucial for better risk stratification.

Purpose of the Study:

• To discuss the evolving concept of lobular neoplasia, particularly its role as a risk factor versus a precursor to invasive carcinoma.
• To highlight the impact of molecular biology and immunoprofiles in defining lobular phenotypes and their association with invasive cancers.
• To address the challenges posed by mass screening in detecting lobular disease via mammography and the implications for managing patients.

Main Methods:

• Review of recent literature on lobular neoplasia, histopathology, molecular biology, and mammographic screening.
• Analysis of evolving diagnostic criteria and their impact on patient management.
• Discussion of immunoprofile data linking lobular phenotypes to invasive breast cancer.

Main Results:

• Molecular data and immunoprofiles increasingly link lobular phenotypes to invasive carcinoma, prompting re-evaluation of lobular neoplasia's precursor status.
• Mammography's effectiveness in detecting lobular disease is being reassessed, challenging prior assumptions.
• Optimal management strategies for lobular neoplasia identified on needle core biopsies are under active debate.

Conclusions:

• The classification and understanding of lobular neoplasia are dynamic, influenced by advancements in molecular pathology and imaging.
• There is a growing consensus that lobular neoplasia may be more directly linked to invasive cancer than previously thought.
• Further research and consensus are needed to establish optimal diagnostic and management pathways for lobular neoplasia.