Advertisement

Lobular Carcinoma In Situ

  • Anjali R. Thawani
  • Lillian M. ErdahlEmail author
Chapter

Abstract

Lobular carcinoma in situ (LCIS) is a high-risk atypical breast lesion associated with an increased risk of breast cancer in either breast. It is most often found incidentally during a breast biopsy. Management of classis LCIS focuses first on confirming radiology-pathology concordance for the imaging abnormality that was biopsied. Excisional biopsy should be performed for associated lesions such as masses or radial scar or discordant findings. If there are no high-risk features on biopsy, then management of LCIS should focus on breast cancer high-risk screening and risk reduction with hormonal therapy or surgery. Pleomorphic LCIS is a special subtype which should typically be excised to negative margins with surgical treatment and adjuvant therapy discussed in a multidisciplinary physician team.

Keywords

Lobular carcinoma in situ LCIS breast atypia high-risk 

References

  1. 1.
    Haagensen CD, Lane N, Lattes R, et al. Lobular neoplasia (so-called lobular carcinoma in situ) of the breast. Cancer. 1978;42(2):737–69.CrossRefGoogle Scholar
  2. 2.
    Degnim AC, King TA. Surgical management of high-risk breast lesions. Surg Clin North Am. 2013;93(2):329–40.CrossRefGoogle Scholar
  3. 3.
    Rendi MH, Dintzis SM, Lehman CD, et al. Lobular in-situ neoplasia on breast core needle biopsy: imaging indication and pathologic extent can identify which patients require excisional biopsy. Ann Surg Oncol. 2012;19(3):914–21.CrossRefGoogle Scholar
  4. 4.
    National Comprehensive Cancer Network. Clinical practice guidelines in oncology. Breast cancer. Version 4.2017. https://www.nccn.org/professionals/physician_gls/pdf/breast.pdf. Accessed 2/2018.
  5. 5.
    Landercasper J, Linebarger JH. Contemporary breast imaging and concordance assessment: a surgical perspective. Surg Clin North Am. 2011;91(1):33–58.CrossRefGoogle Scholar
  6. 6.
    Murray MP, Luedtke C, Liberman L, et al. Classic lobular carcinoma in situ and atypical lobular hyperplasia at percutaneous breast core biopsy: outcomes of prospective excision. Cancer. 2012;119(5):1073–9.CrossRefGoogle Scholar
  7. 7.
    King TA, Pilewskie M, Muhsen S, et al. Lobular carcinoma in situ: a 29-year longitudinal experience evaluating clinicopathologic features and breast cancer risk. J Clin Oncol. 2015;33(33):3945–52.CrossRefGoogle Scholar
  8. 8.
    National Comprehensive Cancer Network. Clinical practice guidelines in oncology. Breast cancer. Genetic/familial high-risk assessment: breast and ovarian. Version 3.2017. https://www.nccn.org/professionals/physician_gls/pdf/genetics_screening.pdf. Accessed 2/2018.
  9. 9.
    Fisher B, Costantino JP, Wickerham DL, et al. Tamoxifen for prevention of breast cancer: report of the National Surgical Adjuvant Breast and Bowel Project P-1 Study. J Natl Cancer Inst. 1998;90(18):1371–88.CrossRefGoogle Scholar
  10. 10.
    Vogel VG, Costantino JP, Wickerham DL, et al. Effects of tamoxifen vs raloxifene on the risk of developing invasive breast cancer and other disease outcomes: the NSABP study of tamoxifen and raloxifene (STAR) P-2 trial. JAMA. 2006;295(23):2727–41.CrossRefGoogle Scholar
  11. 11.
    De Brot M, Mautner SK, Muhsen S, et al. Pleomorphic lobular carcinoma in situ of the breast: a single institution experience with clinical follow-up and centralized pathology review. Breast Cancer Res Treat. 2017;165:411–20.CrossRefGoogle Scholar
  12. 12.
    Flanagan MR, Rendi MH, Calhoun KE, Anderson BO, Javid SH. Pleomorphic lobular carcinoma in situ: radiologic-pathologic features and clinical management. Ann Surg Oncol. 2015;22(13):4263–9.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Division of Surgical OncologyAMITA Health SystemElk Grove VillageUSA
  2. 2.Department of SurgeryUniversity of IowaIowa CityUSA

Personalised recommendations