Lobular neoplasia of the breast: 68 years on

Lobular neoplasia, which encompasses both atypical lobular hyperplasia and lobular carcinoma in situ, is traditionally considered a risk lesion that indicates an increased relative risk of the affected woman for subsequent breast cancer development. Recent molecular genetic information on this entity, however, has provided additional insights into the biology of this incompletely understood disease. Recognition of variants of lobular carcinoma in situ has also led to dilemmas in optimal management, and the advent of pre-operative core biopsies for radiologically detected lesions has created uncertainties regarding how best to handle incidentally discovered lobular neoplasia on these biopsy cores. This article provides an overview of existing concepts, diagnostic pitfalls, pathobiology and current management approaches for this enigmatic lesion.