Lobular Carcinoma In Situ

Lobular carcinoma in situ is not a cancer in itself, but an indicator that a patient’s chance of having breast cancer in the future is increased. This condition is characterized by an area of abnormal tissue growth that stays within or occurs within the milk glands or lobules at the breast duct ends. It is estimated that about 10 to 20 percent lifetime risk of invasive breast cancer is possible for women with this condition.

Causes

Why this condition occurs is unknown. It is not known if genetic mutations play a role and as of today no specific genes have been shown to be associated with developing this condition. The BRCA1 and BRCA2 genes are not shown to play a role either. It is also unclear whether or not there is a link between this condition and hormonal or environmental exposures, or family history of breast cancer.

Signs and Symptoms

Signs and symptoms do not typically occur with lobular carcinoma in situ. There usually aren’t any visual abnormalities or lumps for a mammogram to detect.

Diagnosis

A mammogram is usually not effective in diagnosing this condition. In most cases, this condition is diagnosed unintentionally when the patient is being evaluated for something else through the use of a biopsy. Several types of biopsies may be helpful in diagnosing this condition. A fine-needle aspiration biopsy involves a very fine needle being carefully inserted directly into the breast lump. The doctor will then use a syringe, attached to the fine needle, to extract a fluid or cell sample for further evaluation.

A surgical biopsy involves an incisional biopsy to remove a piece of the breast lump or an excisional biopsy to remove the entire breast lump. The sample or entire lump will be further evaluated.

A core needle biopsy is performed by a surgeon or radiologist. The doctor will use a hollow, thin needle to obtain several small tissue samples from the mass in the breast. To help guide the needle, the doctor will often use ultrasound or mammography.

Treatment

Once diagnosed, many doctors recommend observation. This may include yearly mammograms, breast MRI, frequent self-exams of the breasts, and twice yearly clinical breast exams.

Chemoprevention may done for some patients. This involves using a selective estrogen receptor modulator to try and reduce the patient’s risk of invasive breast cancer. These drugs work by blocking the receptivity of breast tissues to estrogen. Blocking this receptivity may help to prevent the growth of breast tumors. Commonly used chemoprevention medications include raloxifene and tamoxifen.

Preventative therapy may also be beneficial to some patients. A preventative mastectomy is a surgical procedure in which a surgeon removes both breasts to reduce the patient’s risk of falling victim to invasive breast cancer. This is a major, life-changing surgery and while it is greatly beneficial to many patients, all patients should carefully evaluate the pros and cons before going under the knife.

Resources

MayoClinic.com. (2009). Lobular Carcinoma in situ. Retrieved on November 20, 2010 from MayoClinic.com: https://www.mayoclinic.com/health/lobular-carcinoma-in-situ/DS00982

Stanford Medicine Cancer Center. (2010). Lobular Carcinoma in situ. Retrieved on November 20, 2010 from Stanford Medicine Cancer Center: https://cancer.stanford.edu/breastcancer/lcis.html