Lobular Carcinoma In Situ - LCIS
What is lobular carcinoma in situ?
Lobular carcinoma in situ (LCIS) is a condition in which cellular abnormalities develop in the lobes of the breast tissue. The lobes are the grape-like clusters of cells where milk forms during lactation. The milk then flows through the ducts to the nipple. Each breast contains five to nine separate ductal systems. The cells in these tissues are highly proliferative: as part of the menstrual cycle, they divide and grow rapidly, preparing the body for a possible pregnancy. Since these cells divide rapidly, they are more likely to develop abnormalities such as LCIS. That is why most cases of LCIS occur in premenopausal women.
How is LCIS diagnosed?
Lobular carcinoma in situ is rarely found when screening for breast cancer. It is usually found only after a pathologist looks at cells from a biopsy that was ordered because of a suspicious mammogram or the discovery of a lump. Abnormalities that have developed in the cells in the lobes of the milk duct system are discovered through tissue sample analysis.
Is LCIS an early cancer or precancer?
No. Lobular carcinoma in situ is a risk factor for cancer rather than an early cancer. It causes no lumps and is invisible on mammogram. Although LCIS is sometimes categorized as stage 0 cancer or noninvasive cancer, it is not cancer at all and is not even a precancerous condition. Nevertheless, a woman who has LCIS has an above-average risk of developing real (invasive) breast cancer in the future.
What are the treatments for LCIS?
There is no treatment for LCIS itself. The condition does not require surgery -- not even a lumpectomy, since there isn't any lump. It does not require radiation or chemotherapy. If you are diagnosed as having this rarely-discovered risk factor, your doctor will probably recommend annual mammograms and twice-yearly physical exams.
As recently as 10–20 years ago, few breast specialists knew very much about this uncommon condition. Many physicians were taught that the surgical removal of the affected breast -- or even both breasts -- was probably the best treatment choice. In recent years, physicians and surgeons at university medical centers or specialized breast diagnostic units have become more familiar with the diagnosis and management of LCIS and no longer recommend such radical treatment. If you are diagnosed with LCIS, you might consider going to a center that specializes in the screening and diagnosis of breast cancer to get a second opinion on the best treatment and management of your condition.
You might also want to discuss the pros and cons of using risk-reduction drugs such as tamoxifen or raloxifene. Another option is to consider entering a clinical trial sponsored by the National Cancer Institute to help test other agents that might prevent the development of breast cancer. (A list of such trials and information about enrollment can be found at the National Cancer Institute or by calling the NCI at 1-800-4-CANCER.)
