1. What is lobular neoplasia?
Lobular neoplasia is a benign (not cancer) condition.
Breasts are made up of lobules (milk-producing glands) and ducts (tubes that carry milk to the nipple). These are surrounded by tissue that gives breasts their size and shape.
When lobular neoplasia occurs, there’s an increase in the number of cells contained in the lobules and a change in their appearance and behaviour.
2. Types of lobular neoplasia
There are different types of lobular neoplasia. These are:
- Atypical lobular hyperplasia (ALH)
- Classical lobular carcinoma in situ (LCIS)
- Pleomorphic lobular carcinoma in situ (PLCIS)
‘In situ’ means the changes only occur in the breast lobules and do not affect the surrounding breast tissue.
When tissue is examined under a microscope, ALH and classical LCIS can look very similar. It’s sometimes difficult to separate the 2 conditions and they may both be described as lobular neoplasia.
PLCIS is made up of larger, more abnormal cells.
3. Who lobular neoplasia affects
Lobular neoplasia is most common in women aged 40 to 50, but it can be found in women of any age.
It can be found in men, but this is extremely rare.
4. Diagnosing lobular neoplasia
Mammogram and breast ultrasound
Lobular neoplasia doesn’t usually cause any symptoms or show up on a mammogram.
It’s usually found during a biopsy or other test being done for another breast change. For example, when calcifications (small spots of calcium) are detected on a .
If lobular neoplasia is found by a core biopsy, your specialist may recommend removing more tissue from the area where the lobular neoplasia was found. This is to check if there are any cancer cells in this part of the breast.
This may be done using one of the following:
- Core biopsy – using a hollow needle to take a sample of tissue, under local anaesthetic, to be looked at under a microscope (several tissue samples may be taken at the same time)
- Vacuum assisted excision biopsy – a hollow probe connected to a vacuum is used to take a sample of tissue, under local anaesthetic, to be looked at under a microscope
- Excision biopsy – a sample of breast tissue is removed and looked at under a microscope. An excision biopsy can be carried out under a local or general anaesthetic
A mammogram or ultrasound scan may also be used to help identify the area. Your treatment team will talk to you about which procedure is best for you.
5. Treating lobular neoplasia
ALH and classical lobular carcinoma in situ (LCIS)
You will not usually need treatment for ALH and classical LCIS, but your specialist may discuss treatment options with you based on current guidelines and your individual situation.
Pleomorphic lobular carcinoma in situ (PLCIS)
If the biopsy shows PLCIS, your specialist may suggest an operation to remove the area with a margin (border) of healthy breast tissue. This is because of the higher risk of breast cancer with this type of lobular neoplasia. The operation will show if there are any cancer cells in the tissue, and if all the PLCIS has been removed.
PLCIS is often treated in the same way as ductal carcinoma in situ (DCIS), which is a type of early breast cancer.
or may be recommended.
6. Lobular neoplasia and breast cancer risk
Most women diagnosed with ALH or classical LCIS will never get breast cancer. However, there is a slightly higher risk than the general population of developing breast cancer in either breast.
Women diagnosed with PLCIS are more at risk of developing breast cancer than those with ALH or classical LCIS.
Your individual risk depends on several factors, which your specialist can discuss with you.
Research has shown that treating women who have lobular neoplasia with - a hormone therapy treatment for breast cancer - can reduce the risk of breast cancer developing.
However, any possible benefit of taking tamoxifen needs to be considered against the risks and side effects of this treatment. Your specialist will discuss with you if this might be an option.
Family history: Assessing your breast cancer risk
Your specialist will usually recommend having yearly follow-up mammograms for up to 5 years.
If you have other risk factors for breast cancer, such as a significant family history, scans may be recommended, such as an MRI (magnetic resonance imaging) scan. Your specialist will discuss which follow-up is best for you.
8. Other important information
Hormone replacement therapy (HRT)
and oral contraceptives are not usually recommended for people after a diagnosis of lobular neoplasia.
9. Further support
Finding out that you have lobular neoplasia can leave you feeling different emotions. Fear, shock and anger are all common feelings. Although lobular neoplasia is not breast cancer, it can cause uncertainty about your future risk of breast cancer and you may feel anxious.
If you’re worried about breast cancer or have a question about lobular neoplasia, our specialist team are ready to listen on our free helpline. See below for ways to get in touch.