Lobular Breast Carcinoma in Situ(LCIS)

Symptoms

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Lobular Carcinoma In Situ (LCIS) is a type of abnormal cell change which starts in the cells of a part of the breast known as the 'lobules'.

The normal brest anatomy consists mainly of milk-producing lobules and ducts to carry the milk. Each breast has about 20 lobules which are drained by ducts to carry the milk to the nipples.

LCIS develops in these lobules but does not break through the basement membrane to spread to the surrounding tissue.

'In situ' is a Latin word meaning 'in place'. LCIS is also referred to as TIS, which means 'tumor in situ' or 'in the same place'.

LCIS is not a cancer but a precancerous condition. Presence of LCIS indicates that the woman is at a higher risk of developing invasive lobular breast carcinoma (ILC) in later life. So, some researchers prefer the term 'lobular neoplasia' instead of 'lobular carcinoma'. A neoplasia is a collection of abnormal cells.

About 25% of women with LCIS will develop ILC. Time to invasive lobular breast carcinoma (ILC) after initial diagnosis of LCIS on biopsy is usually 15 - 30 years.

Lobular breast carcinoma is the second most common type of breast cancer. It is less common than invasive ductal breast cancer and more common than other types of breast cancers like Inflammatory Breast cancer and Paget's Disease of the Breast .

Lobular Breast Cancer in Situ
LOBULAR CARCINOMA IN SITU

Age

LCIS commonly occurs at around the the ages of 40 and 50 years. It is more common before menopause has occured and is extremely rare in men.

Epidemiology

  • Estimated incidence is about 2.7 % ( 2.7 per 100K women)
  • It is present is about 0.5 to 3.8% of breast tissues removed for benign causes.
  • Mean age of occcurance is 44 - 46 years
  • It is often an incidental microscopic finding
  • It is not associated with the presence of microcalcifications in the breast.
  • It is often multicentric (occurring in more than one place in the same breast) and frequently bilateral (occurs in both breasts).
  • It increses the risks of developing invasive breast cancer.
  • The risk of invasive carcinoma after a diagnosis of LCIS is approximately 10-12 % after 10 years.

Breast Cancer Screening guidelines for women with LCIS.

  • Have a clinical breast exam every 6-12 months
  • Have a mammogram every year, starting at age 30
  • If family risk and other risk factors are present, screening with breast MRI every year, starting at age 25.
  • Women with LCIS may be advised to take risk lowering drugs like tamoxifen or raloxifene to lower their risk of breast cancer.
Symptoms of Lobular Breast Cancer (LCIS):
  • No Symptoms: In most cases, LCIS produces no symptoms of breast cancer at all. It may be diagnosed only after biopsy of a suspicious lump seen at routine mammography or physical examination. LCIS frequently does not show up in a mammography.

  • Breast Lump: In some cases, a small lump may be felt in a part of the breast. But again, it is only after a biopsy that LCIS can be definitely diagnosed. These lumps, as in most breast cancers, are also non-tender and firm lumps.

  • Nipple Discharge: LCIS rarely produces nipple diischarge.

  • Pain: Pain is very uncommon. But in the presence of infection of the lump, there may be some amount of pain.

Stages of LCIS:

LCIS is generally considered to be Stage O of Breast cancer since it is non-invasive, although many researchers prefer to think of it as a marker for breast cancer rather than a true precursor of breast cancer.


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