The cross cultural context of obesity: an INCLEN multicentre collaborative study

Associations between obesity and cardiovascular disease have been documented in the Developed World and have been linked with levels of 'development' in Developing World countries. This study aimed to explore the sociocultural influences on attitudes towards obesity, physical activity and dietary change using a four level conceptual framework (from personal to societal influences). Focus group discussions were conducted in: India, Indonesia, Cameroon, Egypt and Australia. The results of these discussions were analysed to reveal emergent themes. The interpretation of the qualitative data emphasised the need to incorporate influences beyond the individual in efforts to reverse or prevent obesity related disease.

Lobular carcinoma in situ at percutaneous breast biopsy: surgical biopsy findings

OBJECTIVE

The purpose of this study was to review surgical histologic findings in women with lobular carcinoma in situ (LCIS) at percutaneous breast biopsy.

MATERIALS AND METHODS

Retrospective review was performed of 1315 consecutive lesions that underwent percutaneous breast biopsy. Percutaneous biopsy yielded LCIS in 16 (1.2%) lesions. Subsequent surgical biopsy was performed in 14 lesions in 13 women. Histologic findings were reviewed.

RESULTS

In five of the 14 lesions, percutaneous biopsy yielded LCIS and a high-risk lesion (radial scar in three and atypical ductal hyperplasia in two); in one (20%) of these five lesions, surgery revealed ductal carcinoma in situ (DCIS). In four of the 14 lesions, the LCIS in the percutaneous biopsy had features that overlapped with those of DCIS; in two (50%) of these four lesions, surgery revealed DCIS (n = 1) or infiltrating lobular carcinoma (n = 1). In the remaining five of the 14 lesions, surgery revealed no DCIS or infiltrating carcinoma. Five (38%) of 13 women with LCIS lesions had synchronous or metachronous infiltrating carcinoma (three ductal, one lobular, one mixed) in the ipsilateral (n = 1) or contralateral (n = 4) breast.

CONCLUSION

Surgical excision was warranted in lesions in which LCIS was found at percutaneous breast biopsy when the percutaneous biopsy histologic features overlapped with those of DCIS, when a high-risk lesion was present, or when there was imaging-histologic discordance. LCIS without these factors was not shown to require surgical excision in our small series, but a larger study is needed. Diagnosis of LCIS at percutaneous biopsy is a marker for women who are at increased risk of ductal or lobular carcinoma in either breast.