By Dr. Kathleen Ruddy
Lobular carcinoma in situ, LCIS, was once considered a premalignant lesion for which bilateral mastectomy was recommended. This is no longer the case. Recent studies indicate that LCIS is infrequently a precursor to invasive breast cancer. Thus, radical surgery is no longer required. Close observation is sufficient for most women diagnosed with LCIS, as they have only a slightly increased risk for breast cancer compared to healthy women.
What is lobular carcinoma in situ (LCIS)?
Lobular carcinoma in situ (LCIS) is a benign condition of the breast in which abnormal cells are found and confined to the lobules of the breast. The lobules are organs within the breast that make milk. The ducts of the breast, where the majority of breast cancers occur, carry the milk from the lobules to the nipple.
Is LCIS a precursor to invasive breast cancer?
In most circumstances, LCIS is not considered a precursor to breast cancer. LCIS is a collection of abnormal cells contained within the lobules of the breasts, indicating only that the patient has an increased risk for future breast cancer in either breast. LCIS itself infrequently progresses to invasive lobular carcinoma and, therefore, patients with LCIS can be followed closely without the need for radical surgery or drugs.
DID YOU KNOW?
Researchers now believe that there is a genetic predisposition to LCIS, but they have not yet identified the specific genes associated with this benign abnormality.
How is LCIS usually diagnosed?
Most commonly, LCIS is found during a routine breast biopsy for other causes. LCIS does not produce a lump or mass. It does not produce abnormalities on mammogram or breast ultrasound. Consequently, LCIS is an incidental finding discovered when a biopsy is done for other reasons.
Should a patient diagnosed with LCIS on needle biopsy have lumpectomy?
A patient who has a needle biopsy for other reasons, like a lump or a mammogram abnormality, and is found to have LCIS should have a lumpectomy to make sure that there are no other true cancers present in the surrounding tissue.
How often is LCIS diagnosed in breast biopsies?
LCIS is found in approximately 0.5% to 3.8% of all benign breast biopsies.
Are there any other common characteristics of LCIS?
If looked for, LCIS is commonly found in multiple areas of the breast. It frequently occurs in the opposite breast as well. Approximately 50% of patients will have multiple spots of LCIS in the breast where it is initially discovered, and 30% of patients will have spots of LCIS in the opposite breast.
What is the risk for breast cancer in women diagnosed with LCIS?
Women diagnosed with LCIS have approximately a 1% to 2% increased risk of breast cancer per year compared to otherwise healthy women. Overall, the increased risk for breast cancer in women with LCIS is still relatively low and, therefore, does not necessarily require radical surgery or drug therapy.
Lobular carcinoma in situ, LCIS, is a collection of abnormal but benign cells confined to the lobules of the breast. In the past, scientists believed that LCIS invariably led to invasive breast cancer and, thus, patients were treated with bilateral mastectomy. More recently, scientists have discovered that LCIS is infrequently a precursor to breast cancer, per se, but rather a marker of increased risk for breast cancer in women in which it is found. Most often, LCIS is an incidental finding discovered during an otherwise normal breast biopsy. Close observation is frequently all that is required for the majority of women diagnosed with LCIS today.
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