Lobular carcinoma in situ

Dr Henry Knipe and Radswiki et al.

Lobular carcinoma in situ (LCIS) represents the next step up from atypical lobular hyperplasia (ALH) along the malignant spectrum of lobular breast carcinoma.

LCIS occurs predominantly in premenopausal women with a mean age of 45 years old, approximately 10-15 years younger than the mean age when invasive breast carcinoma occurs.

Like most other lobular breast pathology, LCIS originates in the terminal ductal lobular unit (TDLU). However unlike ALH,  the malignant cells fill and distend the lobular acini in LCIS. Unlike invasive lobular carcinoma, they leave the basement membrane intact. They do not express E cadherin.

LCIS is usually incidentally identified histologically in breast tissue biopsied for other reasons. The exception may be pleomorphic LCIS which is a more aggressive subtype which may be associated with mammographically detectable calcifications 2.

A substantial percentage of patients with LCIS have no abnormality on mammography. Non-specific microcalcifications are often the impetus for biopsy in the cases when LCIS is discovered.

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.

Approximately 20% (range 18-25%) of cases diagnosed with LCIS at core needle biopsy were upgraded to more invasive cancer pathologies at surgical excision. Therefore when LCIS is discovered on a needle biopsy specimen, an excisional biopsy should be performed.

LCIS was initially first described by F W Foote and F W Stewart in 1941 4

Breast imaging and pathology
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Article information

rID: 12685
System: Breast
Section: Pathology
Tag: cases
Synonyms or Alternate Spellings:
  • Lobular carcinoma in situ (LCIS)
  • LCIS
  • LCIS breast

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