Lobular carcinoma in situ (LCIS)

Description

Lobular carcinoma in situ (LCIS) is a rare condition in which abnormal cells form in the milk glands (lobules) of the breast. Lobular carcinoma in situ (LCIS) is not cancer. But being diagnosed with LCIS indicates that you have a higher risk of developing breast cancer.

LCIS, in general, do not show up on mammograms. The condition is most often discovered as a result of a breast biopsy performed for another reason, such as a suspicious breast lump or an abnormal mammogram.

Women with LCIS have an increased risk of developing invasive breast cancer in either breast. If you are diagnosed with LCIS , your doctor may recommend increasing breast cancer screening and may ask you to consider the possibility of medical treatments in order to reduce your risk of developing invasive breast cancer.

Symptoms

LCIS does not cause signs or symptoms. Rather, your doctor may discover for certain that you have LCIS — for example, after a biopsy to evaluate a breast lump or an abnormal area found on a mammogram.

When to see a doctor

Make an appointment with your doctor if you notice a change in your breasts, such as a lump, an area of puckered or otherwise unusual of the skin, thickening of the region under the skin or nipple discharge.

Ask your doctor when you should consider the possibility of breast cancer screening and how often it should be repeated. Most groups recommend you consider the routine detection of breast cancer beginning in their 40s. Talk with your doctor about what is right for you.

Causes

It is not clear what causes the LCIS . LCIS begins when cells in a milk producing gland (lobe) of a breast develop genetic mutations that cause cells to appear abnormal. The abnormal cells remain at the lobe and do not spread into, or invade, nearby breast tissue.

If LCIS is detected in a biopsy of the breast, this does not mean that you have cancer. But having LCIS increases the risk of breast cancer and makes it more likely that you can develop invasive breast cancer.

The risk of breast cancer in women diagnosed with LCIS, about 20 percent. Put another way, for every 100 women diagnosed with LCIS , 20 will be diagnosed with breast cancer and 80 will not be diagnosed with breast cancer. The risk of developing breast cancer to women in general, it is thought that the 12 per cent. Put another way, for every 100 women in the general population, 12 will be diagnosed with breast cancer.

Your individual risk of breast cancer is based on many factors. Talk with your doctor better understand your personal risk of breast cancer.

Lobular carcinoma in situ (LCIS)

Diagnosis

Lobular carcinoma in situ (LCIS) may be present in one or both breasts, but is not usually visible on a mammogram. The condition is most often diagnosed as an incidental finding when you have a biopsy is performed to evaluate some other area of concern in her womb.

Types of breast biopsy that may be used include:

  • Core needle biopsy. A radiologist or the surgeon uses a thin, hollow needle to remove several small samples of tissue. Imaging techniques, such as ultrasound or magnetic resonance imaging, are often used to help guide the needle used in a core needle biopsy.
  • Surgical biopsy. A surgeon can perform an operation to remove the cells suspicious for the test.

The tissue that is removed during the biopsy is sent to a lab where the doctors who specialize in the analysis of the blood and the tissues of the body (pathologists) to examine closely the cells to determine if you have Lobular carcinoma in situ (LCIS).

Treatment

A number of factors, including your personal preferences come into play when deciding to undergo treatment for lobular carcinoma in situ (LCIS).

There are three main approaches to the treatment of:

  • Careful observation
  • Taking a medication to reduce the risk of cancer (preventive treatment)
  • Surgery

Observation

If you have been diagnosed with LCIS , your doctor may recommend more frequent exams to closely monitor their breasts for signs of cancer. This may include:

  • Monthly breast self-exams to develop breast familiarity and to detect unusual changes in the breast
  • Clinical breast exams every year by a health care provider
  • Screening mammograms each year
  • The consideration of other imaging techniques such as magnetic resonance imaging of the breast or molecular breast imaging, especially if you have other risk factors for breast cancer, such as a strong family history of the disease

Preventive therapy

Preventive treatment (chemoprophylaxis) it involves taking a medication to reduce the risk of breast cancer.

Preventive treatment options include:

  • Medications that block the hormones attach to the cancer cells.Selective modulator of estrogen receptor (SERMS) drugs act by blocking the estrogen receptors in breast cells so that estrogen is not able to bind to these receptors. This helps to reduce or prevent the development and growth of breast cancers. Tamoxifen is oneapproved to reduce the risk of breast cancer in premenopausal women and postmenopausal women. Raloxifene (Evista) is approved for postmenopausal women to reduce the risk of breast cancer and also to prevent and treat osteoporosis.
  • Medicines that stop the body from producing estrogen after menopause.Aromatase inhibitors are a class of medications that reduce the amount of estrogen produced in your body, depriving cancer cells of the breast of the hormones they need to grow and thrive. Aromatase inhibitors anastrozole (Arimidex) and exemestane (Aromasin) are another option to reduce the risk of breast cancer in postmenopausal women. Studies have found that these drugs can reduce the risk of breast cancer in women at high risk, but who are not approved for use by the Food and Drug Administration.

Medications that block the hormones attach to the cancer cells. Selective modulator of estrogen receptor (SERMS) drugs act by blocking the estrogen receptors in breast cells so that estrogen is not able to bind to these receptors. This helps to reduce or prevent the development and growth of breast cancers.

Tamoxifen is approved to reduce the risk of breast cancer in premenopausal women and postmenopausal women. Raloxifene (Evista) is approved for postmenopausal women to reduce the risk of breast cancer and also to prevent and treat osteoporosis.

Medicines that stop the body from producing estrogen after menopause. Aromatase inhibitors are a class of medications that reduce the amount of estrogen produced in your body, depriving cancer cells of the breast of the hormones they need to grow and thrive.

Aromatase inhibitors anastrozole (Arimidex) and exemestane (Aromasin) are another option to reduce the risk of breast cancer in postmenopausal women. Studies have found that these drugs can reduce the risk of breast cancer in women at high risk, but who are not approved for use by the Food and Drug Administration.

Discuss with your doctor the risks and benefits of taking a medication for the prevention of breast cancer to see if it is the best course of treatment for you. There are pros and cons of different medications, and your doctor can discuss which drug may be best for you, based on your medical history.

You could also consider the possibility of participating in a clinical trial exploring an emerging therapy for the prevention of breast cancer. Ask your doctor if you may be a candidate for current clinical trials.

Surgery

Surgery may be recommended in certain situations. For example, surgery is often recommended for a specific type of LCIS called pleomorphic lobular carcinoma in situ (PLCIS). This type of LCIS is thought to lead to a higher risk of breast cancer is the most common type classic.

pleomorphic lobular carcinoma in situ (PLCIS) can be detected on a mammogram. If the analysis of the biopsy confirms that they have PLCIS , your doctor will recommend surgery. The options may include surgery to remove the area of PLCIS (lumpectomy) or an operation to remove all of the tissue of the breast (mastectomy). In determining what treatment is best for you, your doctor considers that part of your breast tissue is involved with PLCIS , the magnitude of the anomalies detected on your mammogram, if you have a strong family history of cancer and its old.

Your doctor may recommend radiation therapy after lumpectomy surgery in certain situations. You may be referred to a doctor who specializes in the use of radiation to treat cancer (radiation oncologist) to review your situation and discuss your options.

Another option for the treatment of LCIS is preventive (prophylactic) mastectomy. This surgery to remove both breasts — not only of the affected breast with LCIS — to reduce your risk of developing invasive breast cancer. To get the best protection benefit from this surgery, both breasts removed, because LCIS increases the risk of developing breast cancer in either breast. This may be an option if you have other risk factors for breast cancer, as an inherited gene mutation that increases your risk, or a very strong family history of the disease.

Self-care

If you are concerned about your risk of breast cancer, take steps to reduce their risk, such as:

  • Exercise most days of the week. Try to do at least 30 minutes of exercise most days of the week. If you haven't been active lately, ask your doctor if it is ok, and start slowly.
  • Maintain a healthy weight.If your weight is healthy, work to maintain that weight. If you need to lose weight, talk to your doctor about healthy strategies to achieve this. Reduce the number of calories you consume each day, and gradually increase the amount of exercise. Aim to lose weight slowly, about 1 or 2 pounds (about .5 or 1.0 kg) a week.
  • Do not smoke. If you smoke, stop smoking. If you've tried to quit in the past, but have not been successful, ask your doctor for help. Medications, counseling and other options that are available to help you quit smoking for good.
  • Drink alcohol only in moderation, if at all. Limit your alcohol consumption to one drink per day, if you choose to drink.
  • Limit of hormonal therapy for the menopause. If you choose to take hormone therapy for menopause signs and symptoms, limit its use to the lowest dose for the shortest time necessary to provide relief.

Maintain a healthy weight. If your weight is healthy, work to maintain that weight. If you need to lose weight, talk to your doctor about healthy strategies to achieve this.

Reduce the number of calories you consume each day, and gradually increase the amount of exercise. Aim to lose weight slowly, about 1 or 2 pounds (about .5 or 1.0 kg) a week.

Coping and support

Although LCIS is not cancer, it can make you worry about your increase in the risk of future breast cancer. Coping with your diagnosis means to find a long-term way to control the fear and the uncertainty.

These suggestions can help you to deal with a diagnosis of LCIS :

  • Learn enough aboutLCISto make decisions about your care.Ask your doctor questions about your diagnosis and what that means for your risk of breast cancer. The use of this information to research your treatment options. Look to trustworthy sources of information, such as the National Cancer Institute, to find out more. This can make you feel more confident to make decisions about your care.
  • Go to all of your exam appointment.You may experience some anxiety before their breast cancer screening tests. Don't let this anxiety keep you from going to all your appointments. In your place, planning for the future and we hope that you will be anxious. To deal with anxiety, spend time doing things that you enjoy in the days before your appointment. Spend time with friends or family, or find a quiet moment to yourself.
  • Control what you can about your health.Make healthy changes in your lifestyle, so that you can feel better. Choose a healthy diet that focuses on fruits, vegetables and whole grains. Try to be active for 30 minutes most days of the week. Get enough sleep each night so that you wake feeling rested. Find ways to cope with stress in your life.

Learn enough aboutLCISto make decisions about your care. Ask your doctor questions about your diagnosis and what that means for your risk of breast cancer. The use of this information to research your treatment options.

Look to trustworthy sources of information, such as the National Cancer Institute, to find out more. This can make you feel more confident to make decisions about your care.

Go to all of your exam appointment. You may experience some anxiety before their breast cancer screening tests. Don't let this anxiety keep you from going to all your appointments. In your place, planning for the future and we hope that you will be anxious.

To deal with anxiety, spend time doing things that you enjoy in the days before your appointment. Spend time with friends or family, or find a quiet moment to yourself.

Control what you can about your health. Make healthy changes in your lifestyle, so that you can feel better. Choose a healthy diet that focuses on fruits, vegetables and whole grains.

Try to be active for 30 minutes most days of the week. Get enough sleep each night so that you wake feeling rested. Find ways to cope with stress in your life.

Preparing for your appointment

Make an appointment with your doctor if you notice a lump or any other unusual changes in your breasts.

If you have already had a breast abnormality evaluated by a doctor and make an appointment for a second opinion, bring the original of the diagnostic images and the results of the biopsy to your new appointment. These should include your images from mammography, ultrasonography CD and glass slides of your breast biopsy.

Taking these results to his new appointment, or request that the office where her first evaluation was carried out to send the results to your doctor for second opinion.

Here's some information to help you prepare for your appointment, and what to expect from your doctor.

What you can do

  • Write down any symptoms you're experiencing, and for how long. If you have a tumor, the doctor will want to know when detected for the first time and if it seems to have grown.
  • Enter your medical history, including details about prior breast biopsies or benign breast conditions with which you have been diagnosed. Also to mention the radiation therapy that has received, even years.
  • Note any family history of breast cancer or another type of cancer, especially in a first-degree relative, such as your mother or sister. Your doctor will want to know the age of your family member when he or she was diagnosed, as well as the type of cancer he or she had.
  • Make a list of your medications. Include any prescription or over-the-counter medications you are taking, as well as all the vitamins, supplements and herbal remedies. If you are currently taking or have previously taken hormone replacement therapy, sharing this with your doctor.

What to expect from your doctor

Your doctor may ask you a series of questions. Be ready to answer them may reserve time to go over points you want to talk in-depth. Your doctor may ask:

  • Do you have a lump in the breast that can be felt?
  • When did you first notice this lump?
  • Has the lump grown or changed over time?
  • Have you noticed any other unusual changes in your breast, such as the discharge, inflammation or pain?
  • Have gone through menopause?
  • Are using or have used any medications or supplements to relieve the symptoms of menopause?
  • Have you been diagnosed with any of the above breast conditions, including disorders, non-cancerous?
  • Have you been diagnosed with any other medical condition?
  • Do you have any family history of breast cancer?
  • Have you or your close female relatives ever been tested for BRCA mutations?
  • Have you ever had radiation therapy?
  • What is the typical daily diet, including the consumption of alcohol?
  • Are you physically active?

If the biopsy reveals LCIS , it is likely that you will have a follow-up appointment with your doctor. The questions that you can ask your doctor about LCIS include:

  • How much LCIS increase my risk of breast cancer?
  • I have other risk factors for breast cancer?
  • How often should I be screened for breast cancer?
  • What types of detection technology will be more effective in my case?
  • Am I a candidate for medications that reduce the risk of breast cancer?
  • What are the possible complications or side effects of these medications?
  • Which medication do you recommend for me and why?
  • How will you monitor me for the side effects of treatment?
  • Am I a candidate for preventive surgery?
  • In general, how effective is the treatment that you are recommending in women with a diagnosis similar to mine?
  • What lifestyle changes can help reduce my risk of cancer?
  • I need a second opinion?
  • Should I see a genetic counselor?
Symptoms and treatment of Lobular carcinoma in situ (LCIS)