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
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.
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].