Two articles have been published in the past half year that question whether the finding of lobular neoplasia (ALH/LCIS) on core needle biopsy automatically requires surgical excision.

The articles, published in the journals Cancer and Modern Pathology, suggest that in cases where there is no discrepancy between the radiology findings and the pathology findings, patients can be followed instead of having to undergo a definitive surgical procedure.  The articles site the low incidence of finding a more worrisome lesion (such as ductal carcinoma in situ or invasive carcinoma) when their subset of patients underwent surgical biopsy.  These data conflict with prior data that suggested all patients with a diagnosis of ALH or LCIS undergo open biopsy.  More research needs to be done in this area so that doctors will have a more uniform approach to patients diagnosed with lobular neoplasia on core biopsy.

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