Lobular carcinoma in situ of the breast(Long-term followup

Abstract

Ninety‐eight women with lobular carcinoma in situ (LICS) of the breast were identified over a 16‐year period. Consecutive slide review of all breast material over a 12‐year period identified 25 women with LCIS on biopsy who did not undergo mastectomy. Only 1 woman (4%) in a complete followup averaging 17.5 years developed ipsilateral invasive carcinoma. of 32 women with a contralateral breast at risk, 3 (9.7%) developed infiltrating carcinoma. LCIS was found with infiltrating carcinoma, especially of the lobular (small cell) type, with such frequency as to indicate a close relationship. However, the risk of subsequent development of infiltrating carcinoma in the breast with biopsyproven LCIS is shown to be substantially less than indicated by previous authors. This suggests that careful and prolonged followup may suffice for the woman whose breast biopsy contains lobular carcinoma in situ.

Lobular neoplasia: morphology, biological potential and management in core biopsies

“…1,18 They occur predominantly in premenopausal women, with most cases being diagnosed in women between 40 and 50 years of age. 13,[19][20][21][22] They are clinically occult, and although they are often also mammographically silent, a significant minority of lobular neoplasia cases diagnosed on core biopsy have associated microcalcifications. [23][24][25][26] Data derived from the Surveillance, Epidemiology and End Results Program 27 have shown that the ageadjusted, age-specific rates of LCIS among women in the United States has increased fourfold between the late 70s (0.9 per 100 000 person years) and late 90s (3.2 per 100 000 person years).…”

“…11,29,30 LCIS confers B15% absolute risk of developing breast cancer at 15 years, but a significant number of subsequent carcinomas occur more than 15 years after a diagnosis of LCIS. 2,12,[19][20][21] Although lobular neoplasia has been linked to an increased risk of subsequent carcinoma in either breast, 12,13,21 several studies have shown a higher, although not always statistically significant, risk in the ipsilateral breast. 3,14,17,20,30,31 Cancer risk in ALH seems to vary with patient age; an initial diagnosis of ALH in postmenopausal women has been associated with a lower risk of subsequent carcinoma development than in premenopausal women.…”

Lobular Neoplasia: Morphology and Management

“…However, later studies have shown an association between classic types and increased bilateral cancer risk, and therefore these lesions have since been regarded as a risk marker rather than a true precursor. 1,[3][4][5] Because of the recognition of indolent lesions as portending increased cancer risk, many favor the terminology of LN and LIN over the anxiety-producing word carcinoma used in the designation of LCIS (written communication with Kathleen Diehl, MD, member of The Consensus Committee of the American Society of Breast Disease, April 23, 2014). Use of the broader diagnosis of LN also reduces subjectivity related to intraobserver and interobserver variability in distinguishing ALH and LCIS.…”

Is lobular carcinoma in situ as a component of breast carcinoma a risk factor for local failure after breast‐conserving therapy?

“…1 LCIS is typically multicentric and bilateral and has no specific clinical manifestation or radiologic features. [2][3][4] LCIS is usually identified as an incidental pathology finding outside the area of abnormality which prompts a biopsy of the breast. Therefore, the true incidence of LCIS in the general population is unknown.…”

“…Approximately 50% of subsequent breast malignancies occur more than 15 years after LCIS was diagnosed. [2][3][4] There are conflicting reports regarding the type of cancer diagnosed after LCIS, specifically the percentage of invasive lobular carcinoma (ILC), which ranges from 50 -70% of invasive tumors in different series. 2-4,9 -12 The percentage of ILC rises when the original diagnosis of LCIS was made according to rigid criteria.…”