Lobular Carcinoma In Situ Advocacy Sheet

Women who are diagnosed with lobular carcinoma in situ (LCIS) have a 10-20 percent chance of developing invasive breast cancer some time in their life. The condition is often found when a biopsy is conducted of suspicious tissue, or after having an abnormal mammogram.  Our bodies are constantly growing and developing new cells; when this process goes wrong, the buildup of extra cells can turn into a mass of tissue called a growth, tumor, or lump. Breast cancer is caused by this over-production of cells that occurs in the breast tissue. Many growths in the breast can be benign (not cancer), while some may be malignant (cancer).

LCIS is not breast cancer (Stage 0), but a marker for possible future breast cancer. It occurs when abnormal tissue grows and stays in the lobules or milk glands located at the end of the breast ducts. Most women with LCIS exhibit no symptoms of the condition, but some may experience a lump in the breast. Women in their 40s or 50s typically are more commonly diagnosed with LCIS, but older women may also have it.

When you visit your gynecologist, he/she will often perform a breast examination, however, you should also be checking periodically for lumps or other abnormalities in your breasts. When pregnant or during your period, breast tissue can become “lumpy” because of hormones, so suspected growths found during those times (particularly ones that remain after your period or pregnancy) may not be cause for alarm, but should still be checked by your doctor.

If you suspect you may have something wrong with your breasts, it is important to discuss it with your doctor to assure early detection and treatment. Some questions you may want to ask include:

• What causes LCIS? It is unclear what causes LCIS. Experts consider if it results from genetic mutations that occur during your lifetime, or if it can be attributed to family history of breast cancer, environmental factors, or hormonal exposure. No specific genes have been linked to LCIS.
• What tests will the doctor perform? If you have a lump or recently had an abnormal mammogram, the doctor may check suspicious tissue using a fine-needle aspiration biopsy, core needle biopsy, or surgical biopsy. LCIS doesn’t show up on a mammogram.
• How is LCIS treated? The three main approaches for LCIS include:

•Careful observation – frequent breast self-exams, clinical breast exams screening mammograms every year, and other imaging techniques to catch any cancer early.
•Medication (chemoprevention) – selective estrogen receptor modulator (SERM) drugs are used to reduce the risk of developing invasive breast cancer (Tamoxifen, or Raloxifene).
•Preventative surgery – prophylactic mastectomy to prevent the risk of developing breast cancer.
•Clinical trials also may be a choice to help explore emerging therapy for preventing breast cancer (ask your doctor what’s available that may be right for you).

• What is the long term risk of cancer? With LCIS, the biggest long-term risk is recurrence. Many women are treated effectively for LCIS.
• Should I get a second opinion? It is your choice, but you should be your own best advocate. If you want a second opinion, ask for one! Many doctors welcome a second opinion contrary to what you might think. Many insurance companies may cover additional testing performed by a different doctor if your doctor requests it. Some insurance companies even require a second opinion. The short delay taken in getting all the information to allow you to feel more confident and in control of your health in most cases will not be detrimental to your treatment.
• What if the doctor suggests I have a mastectomy? In some cases, for instance, if you have family history of breast cancer, a mastectomy may be an option for you. At that time, you may opt for either breast reconstruction or prosthesis (breast form worn inside your bra). Discuss choices with your doctor to find the solution that’s right for you.
• Is there a cure for breast cancer? While there is no definitive cure for breast cancer, there also is no guarantee that LCIS means you will get breast cancer; it’s a warning. Ongoing research has brought great strides in treatment and detection of breast cancer. With the knowledge, you can decide if you want to treat it, then you can work to lower your risk factors and monitor your health closely to ensure early detection and treatment if you do get it.
• Is there any research I can do on my own and what sources would you recommend? A LCIS diagnosis can be scary, frustrating, and depressing. Your doctors can suggest their preferred reputable web sites and support groups for obtaining more information and helping you cope with the possibility of getting breast cancer at some point in your lifetime.

This information is not meant to be a replacement for talking with your doctor. It is meant to be a catalyst. Talk with your team of doctors to get the full picture for your particular case.

Resources:
www.breastcancer.org LCIS – Lobular Carcinoma In Situ
www.mayoclinic.com Lobular Carcinoma In Situ (LCIS)

Do you have a question about LCIS or cancer? Check out EmpowHER’s pages. Sign-up, post a question, share your story, connect with other women in our community and feel EmpowHERed!

Christine Jeffries is a writer/editor for work and at heart, and lives in a home of testosterone with her husband and two sons. Christine is interested in women’s health and promoting strong women.