Evidence map›Paper›PMID 37114120›Full record

Observational studyThe breast journal2023

Management of Lobular Neoplasia Diagnosed by Core Biopsy.

Chinmay Jani, Margaret Lotz, Sarah Keates, Yasha Gupta, Alexander Walker, Omar Al Omari, Arshi Parvez, Dipesh Patel, Maria Gnata, John Perry and 3 more

Open access · goldAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in The breast journal, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.8field-weighted citation impact, top 28% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 3 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 1 institution in 1 country.

Chinmay JaniDepartment of Internal Medicine, Mount Auburn Hospital, 300 Mount Auburn St., Cambridge, MA, USA.
Margaret LotzHarvard Medical School, 25 Shattuck St, Boston 02115, MA, USA.
Sarah KeatesHarvard Medical School, 25 Shattuck St, Boston 02115, MA, USA.
Yasha GuptaHarvard Medical School, 25 Shattuck St, Boston 02115, MA, USA.
Alexander WalkerDepartment of Internal Medicine, Mount Auburn Hospital, 300 Mount Auburn St., Cambridge, MA, USA.
Omar Al OmariDepartment of Internal Medicine, Mount Auburn Hospital, 300 Mount Auburn St., Cambridge, MA, USA.
Arshi ParvezDepartment of Internal Medicine, Mount Auburn Hospital, 300 Mount Auburn St., Cambridge, MA, USA.
Dipesh PatelHarvard Medical School, 25 Shattuck St, Boston 02115, MA, USA.
Maria GnataHoffman Breast Center, Department of Surgery, Mount Auburn Hospital, 300 Mount Auburn St., Cambridge, MA, USA.
John PerryDepartment of Pathology, Mount Auburn Hospital, 300 Mount Auburn St., Cambridge, MA, USA.
Leila KhorashadiHarvard Medical School, 25 Shattuck St, Boston 02115, MA, USA.
Lisa WeissmannDepartment of Internal Medicine, Mount Auburn Hospital, 300 Mount Auburn St., Cambridge, MA, USA.
Susan E PoriesHarvard Medical School, 25 Shattuck St, Boston 02115, MA, USA.ORCID 0000-0001-7315-9993
Mount Auburn Hospital · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Lobular neoplasia (LN) involves proliferative changes within the breast lobules. LN is divided into lobular carcinoma in situ (LCIS) and atypical lobular hyperplasia (ALH). LCIS can be further subdivided into three subtypes: classic LCIS, pleomorphic LCIS, and LCIS with necrosis (florid type). Because classic LCIS is now considered as a benign etiology, current guidelines recommend close follow-up with imaging versus surgical excision. The goal of our study was to determine if the diagnosis of classic LN on core needle biopsy (CNB) merits surgical excision. This is a retrospective, observational study conducted at Mount Auburn Hospital, Cambridge, MA, from May 17, 2017, through June 30, 2020. We reviewed the data of breast biopsies conducted at our hospital over this period and included patients who were diagnosed with classic LN (LCIS and/or ALH) and excluded patients having any other atypical lesions on CNB. All known cancer patients were excluded. Of the 2707 CNBs performed during the study period, we identified 68 women who were diagnosed with ALH or LCIS on CNB. CNB was performed for an abnormal mammogram in the majority of patients (60; 88%) while 7(10.3%) had an abnormal breast magnetic resonance imaging study (MRI), and 1 had an abnormal ultrasound (US). A total of 58 patients (85%) underwent excisional biopsy, of which 3 (5.2%) showed malignancy, including 2 cases of DCIS and 1 invasive carcinoma. In addition, there was 1 case (1.7%) with pleomorphic LCIS and 11 cases with ADH (15.5%). The management of LN found on core biopsy is evolving, with some advocating surgical excision and others recommending observation. Our data show a change in diagnosis with excisional biopsy in 13 (22.4%) of patients with 2 cases of DCIS, 1 invasive carcinoma, 1 pleomorphic LCIS, and 9 cases of ADH, diagnosed on excisional biopsy. While ALH and classic LCIS are considered benign, the choice of ongoing surveillance versus excisional biopsy should be made with shared decision making with the patient, with consideration of personal and family history, as well as patient preferences.

Indexed as

Breast Carcinoma In SituBreast NeoplasmsCarcinoma in SituCarcinoma, Intraductal, NoninfiltratingCarcinoma, LobularPrecancerous ConditionsBiopsyBiopsy, Large-Core NeedleFemaleHumansHyperplasiaObservational Studies as Topic

Identifiers

PMID37114120
PMCPMC10129432
OpenAlexW4366336687

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.