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 in situ and atypical lobular hyperplasia. Lobular carcinoma in situ is more commonly observed among 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 their early 40s. 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]
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:

Epidemiology and Demographics

Age

Lobular carcinoma in situ is more commonly observed among 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 40s.

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

History and Symptoms

Lobular carcinoma in situ is usually asymptomatic.

Physical Examination

Physical examination of patients with lobular carcinoma in situ is usually unremarkable,

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


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