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Lobular carcinoma in situ (LCIS)

Lobular carcinoma in situ (LCIS) is an uncommon condition in which abnormal cells form in the milk glands (lobules) in the breast. LCIS isn’t cancer. But being diagnosed with LCIS indicates that you have an increased risk of developing breast cancer.

LCIS usually doesn’t show up on mammograms. The condition is most often discovered as a result of a breast biopsy done for another reason, such as a suspicious breast lump or an abnormal mammogram.

Women with LCIS have an increased risk of developing invasive breast cancer in either breast. If you’re diagnosed with LCIS, your doctor may recommend increased breast cancer screening and may ask you to consider medical treatments to reduce your risk of developing invasive breast cancer.

LCIS doesn’t cause signs or symptoms. Rather, your doctor might discover incidentally that you have LCIS — for instance, after a biopsy to assess a breast lump or an abnormal area found on a mammogram.

Make an appointment with your doctor if you notice a change in your breasts, such as a lump, an area of puckered or otherwise unusual skin, a thickened region under the skin, or nipple discharge.

Ask your doctor when you should consider breast cancer screening and how often it should be repeated. Most groups recommend considering routine breast cancer screening beginning in your 40s. Talk with your doctor about what’s right for you.

It’s not clear what causes LCIS. LCIS begins when cells in a milk-producing gland (lobule) of a breast develop genetic mutations that cause the cells to appear abnormal. The abnormal cells remain in the lobule and don’t extend into, or invade, nearby breast tissue.

If LCIS is detected in a breast biopsy, it doesn’t mean that you have cancer. But having LCIS increases your risk of breast cancer and makes it more likely that you may develop invasive breast cancer.

The risk of breast cancer in women diagnosed with LCIS is thought to be approximately 20 percent. Put another way, for every 100 women diagnosed with LCIS, 20 will be diagnosed with breast cancer and 80 won’t be diagnosed with breast cancer. The risk of developing breast cancer for women in general is thought to be 12 percent. Put another way, for every 100 women in the general population, 12 will be diagnosed with breast cancer.

Your individual risk of breast cancer is based on many factors. Talk to your doctor to better understand your personal risk of breast cancer.

Lobular carcinoma in situ (LCIS) may be present in one or both breasts, but it usually isn’t visible on a mammogram. The condition is most often diagnosed as an incidental finding when you have a biopsy done to evaluate some other area of concern in your breast.

Types of breast biopsy that may be used include:

The tissue removed during your biopsy is sent to a laboratory where doctors that specialize in analyzing blood and body tissues (pathologists) closely examine the cells to determine if you have LCIS.

A number of factors, including your personal preferences, come into play when you decide whether to undergo treatment for lobular carcinoma in situ (LCIS).

There are three main approaches to treatment:

Observation

If you’ve been diagnosed with LCIS, your doctor may recommend more frequent exams to closely monitor your breasts for signs of cancer. This may include:

Preventive therapy

Preventive therapy (chemoprevention) involves taking a medication to reduce your risk of breast cancer.

Preventive therapy options include:

Discuss with your doctor the risks and benefits of taking a drug for breast cancer prevention to see if it’s the best course of treatment for you. There are pros and cons to the different medications, and your doctor can discuss which drug may be best for you based on your medical history.

You might also consider participating in a clinical trial exploring an emerging therapy for preventing breast cancer. Ask your doctor whether you might be a candidate for current clinical trials.

Surgery

Surgery may be recommended in certain situations. For instance, surgery is often recommended for a specific type of LCIS called pleomorphic lobular carcinoma in situ (PLCIS). This type of LCIS is thought to carry a greater risk of breast cancer than is the more common classical type.

PLCIS may be detected on a mammogram. If analysis of your biopsy confirms that you have PLCIS, your doctor will recommend surgery. Options may include an operation to remove the area of PLCIS (lumpectomy) or an operation to remove all of the breast tissue (mastectomy). In determining which treatment is best for you, your doctor considers how much of your breast tissue is involved with the PLCIS, the extent of the abnormalities detected on your mammogram, whether you have a strong family history of cancer and your age.

Your doctor may recommend radiation therapy after lumpectomy surgery in certain situations. You may be referred to a doctor who specializes in using radiation to treat cancer (radiation oncologist) to review your specific situation and discuss your options.

Another option for treating LCIS is preventive (prophylactic) mastectomy. This surgery removes both breasts — not just the breast affected with LCIS — to reduce your risk of developing invasive breast cancer. To obtain the best possible protective benefit from this surgery, both breasts are removed, because LCIS increases your risk of developing breast cancer in either breast. This may be an option if you have additional risk factors for breast cancer, such as an inherited gene mutation that increases your risk, or a very strong family history of the disease.

If you’re worried about your risk of breast cancer, take steps to reduce your risk, such as:

Although LCIS is not cancer, it can make you worry about your increased risk of a future breast cancer. Coping with your diagnosis means finding a long-term way to manage your fear and uncertainty.

These suggestions may help you cope with a diagnosis of LCIS:

Make an appointment with your doctor if you notice a lump or any other unusual change in your breasts.

If you have already had a breast abnormality evaluated by one doctor and are making an appointment for a second opinion, bring your original diagnostic images and biopsy results to your new appointment. These should include your mammography images, ultrasound CD and glass slides from your breast biopsy.

Take these results to your new appointment or request that the office where your first evaluation was performed send the results to your second-opinion doctor.

Here’s some information to help you get ready for your appointment, and what to expect from the doctor.

What you can do

What to expect from your doctor

Your doctor is likely to ask you a number of questions. Being ready to answer them may reserve time to go over points you want to talk about in-depth. Your doctor may ask:

If your biopsy reveals LCIS, you’ll likely have a follow-up appointment with your doctor. Questions you may want to ask your doctor about LCIS include:

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