Lobular Carcinoma Insitu

• Chemoprevention:
  • With a selective estrogen receptor modulator:
    • Such as tamoxifen:
      • Substantially reduces the risk of developing invasive breast cancer in patients with lobular carcinoma in situ (LCIS) and should be offered
• Negative margins are generally not required for classic LCIS:
  • Whereas they are recommended for:
    • Pleomorphic LCIS
• The patient’s future risk of developing breast cancer is:
  • Approximately 1% annually
• Bilateral prophylactic mastectomy:
  • Is generally considered to be more invasive than is required in this setting and, although it could be discussed as an option, should not be routinely recommended
• References:
  • Page DL, Kidd TE Jr, Dupont WD, Simpson JF, Rogers LW. Lobular neoplasia of the breast: higher risk for subsequent invasive cancer predicted by more extensive disease. Hum Pathol. 1991;22(12):1232-1239.
  • Andersen JA. Lobular carcinoma in situ of the breast. An approach to rational treatment. Cancer. 1977;39(6):2597-2602.
  • Akashi-Tanaka S, Fukutomi T, Nanasawa T, Matsuo K, Hasegawa T, Tsuda H. Treatment of noninvasive carcinoma: fifteen-year results at the National Cancer Center Hospital in Tokyo. Breast Cancer. 2000;7(4):341-344.
  • Walt AJ, Simon M, Swanson GM. The continuing dilemma of lobular carcinoma in situ. Arch Surg. 1992;127(8):904-907.
  • Haagensen CD, Bodian C, Haagensen DE. Neoplasia (lobular carcinoma in situ). In Breast Carcinoma: Risk and Detection. Philadelphia, PA: WB Saunders, 1981.
  • Wong SM, King T, Boileau JF, Barry WT, Golshan M. Population-based analysis of breast cancer incidence and survival outcomes in women diagnosed with lobular carcinoma in situ. Ann Surg Oncol. 2017;24(9):2509-2517.
  • Fisher ER, Land SR, Fisher B, Mamounas E, Gilarski L, Wolmark N. Pathologic findings from the National Surgical Adjuvant Breast and Bowel Project: twelve-year observations concerning lobular carcinoma in situ. Cancer. 2004;100(2):238-234.

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