Lobular neoplasia (LN) is characterized by a dysfunctional E-cadherin-catenin axis, and loss of E-cadherin plays a causative role in the typical morphology of LN cells. LN is both a nonobligate precursor and a risk indicator of invasive breast cancer, and in particular, of invasive lobular carcinoma. Despite the evidence supporting the precursor role of LN, its impact on clinical management has been a matter of controversy, and conservative management remains the mainstay of treatment. In this article, an update is provided on the pathology and genetics of LN, and the management of these lesions in surgical practice is discussed.