Genco IS, et al. –All breast core needle biopsies (CNB) with a diagnosis of atypical lobular hyperplasia or classic lobular carcinoma in situ from three distinct institutions within a single healthcare system between 2013 and 2018 were pooled in this study in order to examine cases of classic lobular neoplasia diagnosed on CNB to conclude the rate and risk factors of an upgrade to ductal carcinoma in situ or invasive carcinoma on excision. A low upgrade rate (3.8%) on the excision of classic lobular neoplasia diagnosed on breast core needle biopsy was shown. Thus, in individuals without a history of breast cancer, when lobular neoplasia is identified on core biopsy with pathological radiological concordance, clinicoradiological surveillance could be relevant and with the caveat that radiological asymmetry and architectural distortion are related to a notable rise in an upgrade on excision.