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
Lobular carcinoma in situ was first discovered by F W Foote and F W Stewart, in 1941. Lobular carcinoma in situ (LCIS) is a condition in which there is presence of unusual cells in the lobules of the breast.[1]Lobular carcinoma in situ is caused by a mutation in the e-cadherin gene. Lobular carcinoma in situ must be differentiated from other diseases that cause breast lesions, such as ductal carcinoma insitu and atypical lobular hyperplasia. Lobular carcinoma in situ is more commonly observed among patients aged premenopausal women with a mean age of 45 years old. Common risk factors in the development of lobular carcinoma in situ are family history of breast cancer, hormone replacement therapy for menopause, and women in early 40’s. Lobular carcinoma in situ is a high-risk marker for the future development of invasive carcinoma. A woman with lobular carcinoma in situ has approximately a 15-30% chance of developing an infiltrating ductal or lobular carcinoma in the breast in which the lobular carcinoma in situ is discovered or in the contralateral breast. Lobular carcinoma in situ is usually asymptomatic. Lobular carcinoma in situ may be diagnosed using biopsy. Surgical excision is the mainstay of therapy lobular carcinoma in situ.
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 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.[2]
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
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, and women in early 40’s.
Natural History, Complications and Prognosis
- Lobular carcinoma in situ is a high-risk marker for the future development of invasive carcinoma. A woman with lobular carcinoma in situ has approximately a 15-30% chance of developing an infiltrating ductal or lobular carcinoma in the breast in which the lobular carcinoma in situ is discovered or in the contralateral breast.
Diagnosis
Symptoms
- Lobular carcinoma in situ is usually asymptomatic.
Physical Examination
- Patients with lobular carcinoma in situ usually appear normal.
Laboratory Findings
- There are no specific laboratory findings associated with lobular carcinoma in situ.
Imaging Findings
- Mammography is the imaging modality of choice for lobular carcinoma in situ.
Other Diagnostic Studies
- Lobular carcinoma in situ may also be diagnosed using biopsy.
Treatment
Surgery
- Surgical excision is the mainstay of therapy lobular carcinoma in situ.
References
- ↑ 1.0 1.1 "Lobular Carcinoma in situ (LCIS) - Breast Cancer - Stanford Cancer Center".
- ↑ Lobular carcinoma in situ. Wikipedia (2016). https://en.wikipedia.org/wiki/Lobular_carcinoma_in_situ Accessed on April 20, 2016