What is lobular carcinoma in situ (LCIS)?
LCIS is a noninvasive precancer. Lobular means that the unusual cells
are in the lobules, the parts of the breast capable of making milk. If
you have LCIS it means that you have abnormal cells in the lining of a
lobule. Even though LCIS contains the word carcinoma, which means
"cancer," LCIS is not cancer and it is not life threatening.
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How is it treated?
Basically this is a prevention situation: You want to prevent yourself
from ever getting breast cancer. There are a number of options. What's
important is that you give yourself the time to figure out what you
want to do. LCIS doesn't call for an immediate decision. LCIS is a risk
factor for subsequent cancer, not cancer itself. There is no rush to
begin a treatment.
The National Comprehensive Cancer Network
treatment guidelines recommend close follow-up for women with LCIS. If
possible, this should be done at a program for high-risk women. These programs provide
close follow-up, which means clinical breast exams every six months and
yearly mammograms. That way if a cancer does develop, you're likely to
catch it at an early stage and can decide then if you want to have a
mastectomy, or a lumpectomy and radiation.
More controversial is the question of taking tamoxifen
for five years to prevent the subsequent development of breast cancer.
Tamoxifen is a hormone therapy used to treat women with breast cancer
who have hormone-sensitive tumors. It has been shown to decrease the
chance of getting breast cancer by 56 percent in women with LCIS. This
means that the risk becomes 56 percent of the original risk. The
original risk is 1 percent per year, so taking tamoxifen would reduce
your risk to .5 percent a year.
The most drastic
option is bilateral prophylactic mastectomy. Why bilateral (both
breasts)? Because if you have LCIS you have a risk of getting breast
cancer in either breast, not just the breast in which the LCIS is
found. Some women choose this because they want to know they've done
everything they could. They feel that if they get breast cancer, at
least it isn't their fault, whereas if they hadn't done anything
surgically and gotten the disease, they'd always wonder if they could
have prevented it. The reason this is considered drastic is that most
women with LCIS will never go on to develop breast cancer.
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