Lobular Carcinoma In Situ

Rodrigo Arrangoiz MS, MD, FACS, FSSO
  • The rate of cancer development in setting of LCIS:
    • Has been reported to be approximately 2% per year:
      • Translating into a cumulative long-term rate of 26% at 15 years
  • While a minority of patients elect to proceed with bilateral prophylactic mastectomy for LCIS:
    • The estimated breast cancer incidence is generally not considered high enough to justify such extensive surgery
    • Furthermore, women with a history of LCIS:
      • Typically develop low- or intermediate-grade malignancies clinically detected at an early stage
  • Multiple studies support a low upgrade rate on excision (1% to 5% for patients diagnosed with LCIS on core biopsy and rad-path concordant) with a 1% upgrade rate reported in a prospective study with central pathology review:
    • Therefore surgical excision is not routinely indicated
  • The risk conferred by LCIS:
    • Is independent of family history
  • Chemoprevention:
    • Reduces breast cancer risk by 40% to 65% in women at elevated risk:
      • Data from the NSABP P-1 trial suggest that women with LCIS derive even greater benefit than this estimate
  • References:
    • King TA, Pilewskie M, Muhsen S, Patil S, Mautner SK, Park A, et al. Lobular carcinoma in situ: a 29-year longitudinal experience evaluating clinicopathologic features and breast cancer risk. J Clin Oncol. 2015;33(33):3945–3952.
    • 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.
    • Nakhlis F, Gilmore L, Gelman R, et al. Incidence of Adjacent Synchronous Invasive Carcinoma and/or Ductal Carcinoma In-situ in Patients with Lobular Neoplasia on Core Biopsy: Results from a Prospective Multi-Institutional Registry (TBCRC 020). Ann Surg Oncol. 2016;23(3):722-728.
    • King MC, Wieand S, Hale K, et al. Tamoxifen and breast cancer incidence among women with inherited mutations in BRCA1 and BRCA2: National Surgical Adjuvant Breast and Bowel Project (NSABP-P1) Breast Cancer Prevention Trial. JAMA. 2001;286(18):2251-2256.
#Arrangoiz #Surgeon #Doctor #CancerSurgeon #BreastSurgeon #SurgicalOncologist #LCIS #LobularCarcinomaInSitu #MountSinaiMedicalCenter #MSMC #Miami #Mexico
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Published by Rodrigo Arrangoiz MS, MD, FACS, FSSO

My name is Rodrigo Arrangoiz I am a breast surgeon/ thyroid surgeon / parathyroid surgeon / head and neck surgeon / surgical oncologist that works at Center for Advanced Surgical Oncology in Miami, Florida. I was trained as a surgeon at Michigan State University from (2005 to 2010) where I was a chief resident in 2010. My surgical oncology and head and neck training was performed at the Fox Chase Cancer Center in Philadelphia from 2010 to 2012. At the same time I underwent a masters in science (Clinical research for health professionals) at the University of Drexel. Through the International Federation of Head and Neck Societies / Memorial Sloan Kettering Cancer Center I performed a two year head and neck surgery and oncology / endocrine fellowship that ended in 2016. Mi nombre es Rodrigo Arrangoiz, soy cirujano oncólogo / cirujano de tumores de cabeza y cuello / cirujano endocrino que trabaja Center for Advanced Surgical Oncology en Miami, Florida. Fui entrenado como cirujano en Michigan State University (2005 a 2010 ) donde fui jefe de residentes en 2010. Mi formación en oncología quirúrgica y e n tumores de cabeza y cuello se realizó en el Fox Chase Cancer Center en Filadelfia de 2010 a 2012. Al mismo tiempo, me sometí a una maestría en ciencias (investigación clínica para profesionales de la salud) en la Universidad de Drexel. A través de la Federación Internacional de Sociedades de Cabeza y Cuello / Memorial Sloan Kettering Cancer Center realicé una sub especialidad en cirugía de cabeza y cuello / cirugia endocrina de dos años que terminó en 2016.

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