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Literally
meaning in place, the term in situ refers to a very early form of
cancer. In general, the term in
situ is used to indicate that abnormal cancer cells are present but have not spread
past the boundaries of tissues where they initially developed. Lobular carcinoma in situ (LCIS) refers to a
sharp increase in the number, appearance, and abnormal behavior of cells contained in the
milk-producing lobules of the breast (found within the lobes).
Though categorized as a stage 0 breast cancer (the earliest stage), LCIS is not considered
a cancer. Rather, it is marker (a
signal) that breast cancer may develop. In fact,
LCIS has recently been renamed lobular neoplasia to signify this belief. Neoplasia is defined as an abnormal growth in the
number of cells. Though LCIS is not considered a cancer, women who are diagnosed with LCIS
(also called lobular neoplasia) are at a higher risk of developing breast cancer later in
life.
According to the National Cancer
Institute, a woman with LCIS has a 25% chance of developing some form of invasive cancer
(either lobular, or more commonly, infiltrating
ductal carcinoma) within her lifetime.
The
number of women diagnosed with LCIS has increased in recent years, most likely due to more
rigorous breast cancer screening and advances in mammography techniques. Often,
LCIS is encountered serendipitously (by chance) while a pathologist is examining tissue
from a breast biopsy that was performed for another reason (for example, to examine an
area of concern found by physical examination or with
mammography).
Treating
LCIS
Treatment
Options for Women With LCIS |
1.
Close monitoring (includes regular clinical exams, regular screening
mammography, and monthly breast self-exams)
2.
Taking tamoxifen, a hormonal agent, for a period of five years
3.
Enrolling in the STAR clinical trial, which is comparing two drugs,
tamoxifen and raloxifene (must meet eligibility requirements)
4.
Preventive (prophylactic) bilateral mastectomy, usually followed by
breast reconstruction |
Currently, the majority
of women who have been diagnosed with LCIS do not receive treatment after biopsy. Instead, they are closely monitored by physicians
with frequent clinical breast exams and mammograms. It is essential that women with LCIS examine their
breasts carefully, once a month, and see a physician immediately if they notice any changes or abnormalities.
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