Prognostic Significance of Lobular Carcinoma In-Situ (LCIS) Diagnosed Alongside Invasive Breast Cancer

Abstract

Purpose: Women with lobular carcinoma in-situ (LCIS) have an increased risk for developing breast cancer (BC) compared with the general population. However, little is known about the clinical implication of diagnosing LCIS concurrently with an invasive breast cancer. We aimed to define the rate of LCIS diagnosed concurrently with an invasive breast cancer and investigate the risk of contralateral breast cancer (CBC) during survivorship care. Materials and methods: A single center retrospective review over 6 years identified women with stage I-III BC who underwent lumpectomy or unilateral mastectomy. Patients with or without concurrent LCIS were compared using Chi-squared analyses to assess for differences in clinicopathologic factors and risk of future CBC (including invasive and in-situ disease). Results: Of 1808 patients, 16.6% (n = 301) had LCIS concurrent with their index breast cancer. Patients with LCIS had a higher rate of subsequent CBC development than those without LCIS (3.3% versus 1.0%, P = .004). The risk ratio for patients with LCIS developing subsequent CBC compared with those without LCIS was 3.3 (95% confidence interval [CI]: 1.5-7.3). Conclusions: Patients with LCIS diagnosed concurrently with their index breast cancer at surgery are at higher risk for subsequent CBC than those without LCIS. The evidence from this study suggest that it may be appropriate for women with LCIS diagnosed alongside an index breast cancer to consider on-going high-risk screening during survivorship care.

The Metamorphosed Wattle-Lobular Carcinoma in Situ

“…Lobular neoplasia (LN) of breast is comprised of atypical lobular neoplasia (ALH) and lobular carcinoma in situ (LCIS). Classic LCIS exhibits permeation and expansion of >50% of mammary acini with neoplastic cells whereas ALH enunciates < 50% of TDLU pervaded with tumour cells [1,2]. Classic LCIS (c-LCIS) is constituted of type A or type B epithelial cells demonstrating varied morphology.…”

“…Classic LCIS (c-LCIS) is constituted of type A or type B epithelial cells demonstrating varied morphology. Non classical LCIS is comprised of pleomorphic subtype and florid subtype [1,2].…”

“…Classic LCIS represents with lobulo-centric proliferation of monomorphic tumour cells which distend mammary lobular units. Pagetoid involvement of terminal ducts may or may not ensue [1,2]. Characteristically, loosely cohesive, uniformly distributed neoplastic cells, designated as 'marbles in a bag' are discerned.…”

“…Characteristically, loosely cohesive, uniformly distributed neoplastic cells, designated as 'marbles in a bag' are discerned. Tumour cells are mildly enlarged with indistinct cellular perimeter, pale cytoplasm, regular, miniature nuclei, well distributed nuclear chromatin and inconspicuous nucleoli [1,2]. Classic LCIS manifests as a contributor to and non-obligate precursor of invasive carcinoma breast.…”

DCIS and LCIS: Are the Risk Factors for Developing In Situ Breast Cancer Different?

“…However, breast cancer mortality rates remain high in lowerincome countries despite their lower incidence [1,3,4]. Many invasive breast cancers (IBC) are associated with pre-invasive or in situ breast cancer [5,6], which consists of two main histopathological entities: ductal carcinoma in situ (DCIS) and lobular carcinoma in situ (LCIS).…”