Lobular Carcinoma in Situ (LCIS): Symptoms, Causes, Treatment

What are the symptoms of lobular carcinoma in situ?

Lobular carcinoma in situ (LCIS) is a condition where abnormal cells are present in the lobules of the breast, but have not yet invaded the surrounding tissue or spread to other parts of the body. The symptoms of LCIS are often subtle and may not be noticeable in the early stages. However, some women may experience:

1. Breast lump or thickening: A palpable lump or thickening in the breast tissue, which can be felt during a self-examination or by a healthcare provider.
2. Nipple discharge: Clear or bloody nipple discharge, which can be a sign of an underlying abnormality.
3. Skin changes: Changes in the skin around the nipple, such as redness, irritation, or darkening of the skin.
4. Swelling: Swelling in the breast or underarm area on the same side as the affected breast.
5. Pain: Mild to moderate breast tenderness or pain, which can be exacerbated by hormonal changes or menstruation.
6. Breast asymmetry: Changes in breast shape or size, which can be due to uneven growth or shrinkage of the lobules.
7. Axillary lymph node swelling: Swelling of the lymph nodes under the arm on the same side as the affected breast.

It’s essential to note that these symptoms can also be caused by benign conditions or other types of breast cancer, and a definitive diagnosis of LCIS requires a biopsy and histopathological examination.

Women with LCIS are typically at an increased risk of developing invasive breast cancer in either breast, and their healthcare provider may recommend:

1. Regular mammograms: To monitor for any changes in the breast tissue.
2. Breast self-examinations: To perform regular self-examinations to detect any changes in the breast tissue.
3. Genetic testing: To determine if there is a genetic component to their risk of developing breast cancer.

It’s crucial for women with LCIS to work closely with their healthcare provider to develop a personalized plan for monitoring and managing their risk of developing invasive breast cancer.

What are the causes of lobular carcinoma in situ?

Lobular carcinoma in situ (LCIS) is a condition where abnormal cells are present in the lobules of the breast, but have not yet invaded the surrounding tissue or spread to other parts of the body. The exact causes of LCIS are not fully understood, but several factors are thought to contribute to its development:

1. Genetic mutations: Inherited genetic mutations, such as BRCA1 and BRCA2 mutations, can increase the risk of developing LCIS.
2. Hormone exposure: Exposure to hormones, particularly estrogen and progesterone, can stimulate the growth of breast cells and increase the risk of LCIS.
3. Breast density: Women with dense breasts may be at higher risk of developing LCIS due to the increased complexity of breast tissue.
4. Family history: A family history of breast cancer, particularly in first-degree relatives (mother, sister, or daughter), can increase the risk of developing LCIS.
5. Reproductive factors: Women who have not had children or had their first child at an older age may be at higher risk of developing LCIS.
6. Age: LCIS is more common in women over the age of 40.
7. Environmental factors: Exposure to environmental toxins, such as certain chemicals and pesticides, may also play a role in the development of LCIS.
8. Obesity: Being overweight or obese may also increase the risk of developing LCIS.
9. Menopausal status: Women who are postmenopausal may be at higher risk of developing LCIS due to the changes in hormone levels that occur during menopause.
10. Breastfeeding: Women who have never breastfed may be at higher risk of developing LCIS.

It’s essential to note that not all women with these risk factors will develop LCIS, and many women with LCIS may not have any identifiable risk factors.

Women with LCIS are typically at an increased risk of developing invasive breast cancer in either breast, and their healthcare provider may recommend:

1. Regular mammograms: To monitor for any changes in the breast tissue.
2. Breast self-examinations: To perform regular self-examinations to detect any changes in the breast tissue.
3. Genetic testing: To determine if there is a genetic component to their risk of developing breast cancer.

It’s crucial for women with LCIS to work closely with their healthcare provider to develop a personalized plan for monitoring and managing their risk of developing invasive breast cancer.

How is the diagnosis of lobular carcinoma in situ made?

The diagnosis of lobular carcinoma in situ (LCIS) is typically made through a combination of physical examination, imaging studies, and histopathological examination of a breast tissue sample.

The following steps are typically followed to diagnose LCIS:

1. Clinical evaluation: A healthcare provider performs a physical examination of the breast and assesses any changes in the breast tissue.
2. Imaging studies: Imaging studies such as mammography, ultrasound, or magnetic resonance imaging (MRI) may be used to evaluate the breast tissue and detect any abnormalities.
3. Fine-needle aspiration biopsy (FNAB): A healthcare provider performs an FNAB to collect a sample of breast tissue for examination.
4. Core needle biopsy: A core needle biopsy is performed to collect a larger sample of breast tissue for examination.
5. Histopathological examination: The biopsy samples are sent to a laboratory for histopathological examination, where they are examined under a microscope to identify any abnormalities.
6. Pathological diagnosis: A pathologist examines the biopsy samples and makes a diagnosis based on the following criteria:
   • The presence of abnormal cells in the lobules of the breast tissue.
   • The abnormal cells must be confined to the lobules and have not invaded surrounding tissue.
   • The abnormal cells must not be malignant or invasive.

The diagnosis of LCIS is typically made based on the following histopathological features:

• Presence of abnormal cells in the lobules
• Abnormal cells are characterized by changes in cell size, shape, and arrangement
• Abnormal cells may have increased nuclear size, nuclear pleomorphism, or mitotic activity
• There is no evidence of invasion or malignant transformation

In some cases, LCIS may be diagnosed incidentally during surgery or other medical procedures, such as:

• Lumpectomy or mastectomy for suspected breast cancer
• Breast reduction or reconstruction surgery
• Breast implant removal or replacement

It’s essential to work with a healthcare provider and pathologist to determine the correct diagnosis and develop a personalized treatment plan.

What is the treatment for lobular carcinoma in situ?

The treatment for lobular carcinoma in situ (LCIS) is typically focused on managing the risk of developing invasive breast cancer, rather than treating the LCIS itself. The primary goal of treatment is to reduce the risk of invasive breast cancer and improve overall survival.

The treatment options for LCIS may include:

1. Monitoring: Women with LCIS are typically monitored with regular mammograms and clinical breast exams to detect any changes in the breast tissue.
2. Chemoprevention: Hormone therapy medications, such as tamoxifen or raloxifene, may be prescribed to reduce the risk of invasive breast cancer.
3. Targeted therapy: Targeted therapies, such as trastuzumab, may be used to target specific genes or proteins involved in the development and progression of LCIS.
4. Surgery: Some women with LCIS may choose to undergo surgery to remove the affected breast tissue, such as a lumpectomy or mastectomy.
5. Radiation therapy: Radiation therapy may be used in combination with surgery to reduce the risk of recurrence.

The decision to pursue treatment for LCIS should be made on an individual basis, taking into account the woman’s overall health, family history, and personal preferences.

Some women with LCIS may choose to undergo a bilateral mastectomy (removal of both breasts) to reduce the risk of developing invasive breast cancer in either breast.

It’s essential to work closely with a healthcare provider and consider the following factors when making a decision about treatment:

• The woman’s age and menopausal status
• The size and location of the abnormal cells
• The presence of other risk factors for breast cancer
• The woman’s overall health and fitness for surgery
• Personal preferences and values

Women with LCIS should also undergo regular screening tests to monitor for any changes in their breast tissue and detect any signs of invasive breast cancer early.