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Florid Lobular Carcinoma In Situ: Imaging Characteristics and Pathologic Upgrade Rates on Surgical Excision.

Anshumi Desai1, Susan B Kesmodel1,2, Barbara Susnik3

  • 1DeWitt Daughtry Family Department of Surgery, Division of Surgical Oncology Miami, University of Miami, Miami, Florida, USA.

The Breast Journal
|April 8, 2025
PubMed
Summary
This summary is machine-generated.

Florid lobular carcinoma in situ (FLCIS) has a 50% upgrade rate to invasive cancer upon surgical excision, particularly when suspicious calcifications or larger lesions are present. This highlights the need for careful surgical planning and lymph node evaluation.

Keywords:
florid lobular carcinoma in situinvasive lobular carcinomalobular carcinoma in situupgrade rates

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Area of Science:

  • Breast Pathology
  • Surgical Oncology
  • Radiology

Background:

  • Florid lobular carcinoma in situ (FLCIS) is an uncommon variant of lobular neoplasia.
  • FLCIS is often associated with invasive carcinoma, yet management guidelines are limited.
  • This study investigates imaging features predicting upgrade in FLCIS.

Purpose of the Study:

  • To identify imaging features associated with pathologic upgrade rates in FLCIS.
  • To guide surgical management of FLCIS based on core biopsy findings.
  • To evaluate the association between imaging findings and invasive carcinoma development.

Main Methods:

  • Retrospective review of 18 patients with FLCIS on core biopsy undergoing surgical excision.
  • Exclusion of cases with pleomorphic lobular carcinoma in situ.
  • Analysis of clinical, radiologic, and pathologic features, focusing on imaging findings and upgrade rates.

Main Results:

  • Overall upgrade rate to invasive carcinoma was 50% (9/18).
  • Upgrade was significantly higher with suspicious calcifications (73%) and larger lesions.
  • Of upgrades, 89% were invasive lobular carcinoma; 87.5% were Stage I.

Conclusions:

  • FLCIS on core biopsy has a substantial 50% upgrade rate to invasive lobular carcinoma.
  • Suspicious calcifications and larger lesion size are predictors of upgrade.
  • Findings support tailored surgical excision and lymph node assessment for FLCIS.