Lobular carcinoma in situ
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Faizan Sheraz, M.D. [2]; Ammu Susheela, M.D. [3]
Synonyms and keywords: Lobular Carcinoma (in situ); LCIS
Overview
Historical Perspective
- Lobular carcinoma in situ was first discovered by F W Foote and F W Stewart, in 1941.
Pathophysiology
- Lobular carcinoma in situ (LCIS) is a condition in which there is presence of unusual cells in the lobules of the breast.[1]
- The pathogenesis of [disease name] is characterized by [feature1], [feature2], and [feature3].
- The loss of expression of e-cadherin, the transmembrane protein mediating epithelial cell adhesion has been associated with the development of lobular carcinoma in situ.
- The loss of heterozygosity on chromosome 16q has been associated with the development of lobular carcinoma in situ..
- On microscopic histopathological analysis, small cells with oval or round nuclei and small nucleoli detached from each other are mucin-containing signet-ring cells are characteristic findings of lobular carcinoma in situ
Causes
- Lobular carcinoma in situ is caused by a mutation in the e-cadherin gene.
Differentiating Lobular carcinoma in situ from other Diseases
- Lobular carcinoma in situ must be differentiated from other diseases that cause breast lesions, such as:
- Ductal carcinoma insitu
- Atypical lobular hyperplasia
Epidemiology and Demographics
- The prevalence of [disease name] is approximately [number or range] per 100,000 individuals worldwide.
- In [year], the incidence of [disease name] was estimated to be [number or range] cases per 100,000 individuals in [location].
Age
- Lobular carcinoma in situ is more commonly observed among patients aged premenopausal women with a mean age of 45 years old
Risk Factors
- Common risk factors in the development of lobular carcinoma in situ are family history of breast cancer, hormone replacement therapy for menopause, women in early 40’s.
Natural History, Complications and Prognosis
- LCIS is a high-risk marker for the future development of invasive carcinoma. A woman with LCIS has approximately a 15-30% chance of developing an infiltrating ductal or lobular carcinoma in the breast in which the LCIS is discovered or in the contralateral breast.
Diagnosis
Diagnostic Criteria
- The diagnosis of [disease name] is made when at least [number] of the following [number] diagnostic criteria are met:
- [criterion 1]
- [criterion 2]
- [criterion 3]
- [criterion 4]
Symptoms
- [Disease name] is usually asymptomatic.
- Symptoms of [disease name] may include the following:
- [symptom 1]
- [symptom 2]
- [symptom 3]
- [symptom 4]
- [symptom 5]
- [symptom 6]
Physical Examination
- Patients with [disease name] usually appear [general appearance].
- Physical examination may be remarkable for:
- [finding 1]
- [finding 2]
- [finding 3]
- [finding 4]
- [finding 5]
- [finding 6]
Laboratory Findings
- There are no specific laboratory findings associated with [disease name].
- A [positive/negative] [test name] is diagnostic of [disease name].
- An [elevated/reduced] concentration of [serum/blood/urinary/CSF/other] [lab test] is diagnostic of [disease name].
- Other laboratory findings consistent with the diagnosis of [disease name] include [abnormal test 1], [abnormal test 2], and [abnormal test 3].
Imaging Findings
- There are no [imaging study] findings associated with [disease name].
- [Imaging study 1] is the imaging modality of choice for [disease name].
- On [imaging study 1], [disease name] is characterized by [finding 1], [finding 2], and [finding 3].
- [Imaging study 2] may demonstrate [finding 1], [finding 2], and [finding 3].
Other Diagnostic Studies
- [Disease name] may also be diagnosed using [diagnostic study name].
- Findings on [diagnostic study name] include [finding 1], [finding 2], and [finding 3].
Treatment
Medical Therapy
- There is no treatment for [disease name]; the mainstay of therapy is supportive care.
- The mainstay of therapy for [disease name] is [medical therapy 1] and [medical therapy 2].
- [Medical therapy 1] acts by [mechanism of action1].
- Response to [medical therapy 1] can be monitored with [test/physical finding/imaging] every [frequency/duration].
Surgery
- Surgery is the mainstay of therapy for [disease name].
- [Surgical procedure] in conjunction with [chemotherapy/radiation] is the most common approach to the treatment of [disease name].
- [Surgical procedure] can only be performed for patients with [disease stage] [disease name].
Prevention
- There are no primary preventive measures available for [disease name].
- Effective measures for the primary prevention of [disease name] include [measure1], [measure2], and [measure3].
- Once diagnosed and successfully treated, patients with [disease name] are followedup every [duration]. Followup testing includes [test 1], [test 2], and [test 3].