Breast Cancer - Arab Medical Association Against Cancer

Pathology and methods of analysis 79recognition. About 80% of lesions are multifocal and multicentric and 30%bilateral. Despite their name, they finally represent risk lesions as about 20% ofpatients treated by lumpectomy alone develop an infiltrating carcinoma after 10 to25 years.According to the intensity of the proliferation and the cytology 3 differentgroups are distinguished:Atypical lobular hyperplasiaThis lesion (Page) is characterized with small and irregular cells whichincompletely filled in the acini, or involved less than half the acini of a lobule. Therelative risk is estimated about 4 times the risk of the general population. Thislesion could be more associated with an homolateral rather than a bilateral risk ofcancer.Lobular in situ carcinomaThe cells are more homogeneous and completely filled the lumen of the majority ofacini of lobules in at least a minimum of 2 lobules.Despite the term of carcinoma, this lesion is only associated with a high risk ofcancer. After conservative surgery, about 20% of the patients developed homo orcontralateral carcinoma. LCIS’s multifocality is brought to light by all authors, andis estimated at 50 to 70% depending on the seriesPleomorphic lobular in situ carcinoma or LIN3This recently variant of LCIS associates LCIS with specific featureslarge distension of the lumenpresence of comedonecrosis sometimes calcifiedneoplastic cells with large and irregular nucleiThese features might be isolated or more often associated. This variant of LCIS isconsidered more aggressive, with 20 to 60% of microinvasive areas and unlike theclassic LCIS is generally treated by complete surgical excision.2- Ductal Carcinomas In-Situ(DCIS)Until the 1980’s, this type of cancer was detected either by bleeding of the nippleor a mastosic lump in the breast in which DCIS was discovered, or by Paget’snipple disease. In even rarer cases, a focus of microcalcifications was foundaccidentally. Today, it is the opposite, for the majority of DCIS’s are discovereddue to an isolated cluster of microcalcifications. In microscopic terms, DCIScorresponds to a proliferation of cells, which vary in shape and size. These cells