Risk of Lobular Neoplasia Upgrade with Synchronous Carcinoma.

BACKGROUND: Atypical lobular hyperplasia (ALH) and classic lobular carcinoma in situ encompass a spectrum of proliferative lesions known as lobular neoplasia (LN). When imaging-concordant and found in isolation on core needle biopsy (CNB), LN infrequently upgrades to carcinoma on surgical excision, and routine excision is not indicated. Upgrade rates in the setting of synchronous carcinoma are not well studied. PATIENTS AND METHODS: Patients with radiology-pathology concordant synchronous LN and separately biopsied ipsilateral (n = 35) or contralateral (n = 15) carcinoma who underwent excision between 2010 and 2021 were retrospectively identified. Frequency of upgrade, to either invasive or in situ carcinoma, was quantified, and factors associated with upgrade were assessed using Fisher's exact test. RESULTS: The median age was 55 (range 33-74) years. The upgrade rate of LN was 6% and not significantly different between ipsilateral (2.9%) and contralateral (13.3%) carcinoma (p = 0.15). All upgraded LN lesions were ALH on CNB and detected as non-mass enhancement on magnetic resonance imaging (MRI). No additional disease was demonstrated after excision at the site of the original LN CNB in 22.9% (8 out of 35) of ipsilateral and 13.3% (2 out of 15) of contralateral patients. Upgrade was not associated with family history, menopausal status, imaging modality used to detect LN, or extent of LN on CNB (p > 0.05). CONCLUSIONS: Our results demonstrate a low upgrade rate (6%) in our study cohort of LN with synchronous ipsilateral or contralateral carcinoma, which suggests that not all LN mandates excision with synchronous carcinoma. Larger, multi-institution studies are needed to validate these findings.

Impact of Child Interaction With Food Preparation on Vegetable Preferences: A Farm-Based Education Approach.

OBJECTIVE: To identify the impact of child involvement in vegetable preparation on vegetable preference and attitudes toward eating vegetables. DESIGN: Pre-post mixed-methods. SETTING: Food and Farming Camp at a nonprofit urban farm in Sunnyvale, California. PARTICIPANTS: Camp participants aged 8-10 years (n = 34 girls, n = 12 boys), and aged 11-14 years (n = 19 girls, n = 4 boys). INTERVENTIONS: Involvement in vegetable preparation through harvesting, cutting, cooking, and seasoning before consumption. Interviews identified camper perception of vegetable preference and involvement in preparation. MAIN OUTCOME MEASURES: Change in vegetable preference from baseline with and without involvement in vegetable preparation. Attitudes toward involvement in vegetable preparation. ANALYSIS: Adjustment of preferences to baseline followed by tests of hypotheses to identify differences with involvement. Thematic, qualitative coding to identify prevalent themes within interview responses. RESULTS: Younger campers preferred vegetables they prepared (P < 0.05), except for carrots. Campers were more likely to choose vegetables they prepared (P < 0.05). Campers of both age groups were curious to try their vegetable creations and described feelings of pride and responsibility related to preparing vegetables. CONCLUSIONS AND IMPLICATIONS: Involvement with food preparation, in particular in a garden-based setting, may provide an accessible method to improve child vegetable preference.