Doctor, What Should I Do?
September 27, 2006 – Marc Silver
Web Exclusive: Corporations Unite Against Cancer
September 27, 2006 – Elizabeth Whittington
Web Exclusive: What Parents Can Do
September 27, 2006 – Elizabeth Whittington
Web Exclusive: A Lion in the House
September 27, 2006 – Marc Silver
Multiple Myeloma & Leukemia
September 27, 2006 – Elizabeth Whittington
Coping
September 27, 2006 – Christopher Schultz
Legal Rights as a Survivor
September 27, 2006
Bookshelf
September 27, 2006 – Kathy LaTour
House Call
September 27, 2006 – Aman Buzdar
Mitigating Litigation
September 27, 2006 – Elizabeth Whittington
Cancer with a Known Cause
September 27, 2006 – Elizabeth Whittington
Cure Becomes Less Risky
September 27, 2006 – Alice McCarthy
Classifying & Clarifying MDS
September 27, 2006 – Elizabeth Whittington
When the Choice Is Not Cure
September 27, 2006 – Marc Silver
The Scoring System
September 27, 2006
Do Women Under 50 Need Mammograms?
September 27, 2006 – Beverly A. Caley
Watch It or Treat It?
September 27, 2006 – Beverly A. Caley
Sisterhood
September 27, 2006 – Jo Cavallo
Creating a Dragon Boat Team
September 27, 2006 – Elizabeth Whittington
Arms in Motion
September 27, 2006 – Elizabeth Whittington
Job-Searching Hints for Survivors
September 27, 2006 – Elizabeth Whittington
Working Through Caregiver Grief
September 27, 2006 – Elizabeth Whittington
Fatal Fibers
September 27, 2006 – Katy Human
People & Places
September 27, 2006 – Elizabeth Whittington
Back in Action After DCIS
September 27, 2006 – Nancy Reuben Greenfield
Getting the Care You Deserve
September 27, 2006 – Stacy Beller Stryer
Treatment Boost for MDS
September 27, 2006 – Alice McCarthy
Power to the Patient
September 27, 2006 – Marc Silver
In Situ Breast Cancer: Is It Really Cancer?
September 27, 2006 – Beverly A. Caley
The Shadow Survivors
September 27, 2006 – Jo Cavallo
Taming the Dragon
September 27, 2006 – Elizabeth Whittington
The Choice to Work
September 27, 2006 – Elizabeth Whittington
A Waste of Taste
September 27, 2006 – Elizabeth Whittington
A Cunning Predator
September 27, 2006 – Katy Human
Lessons Learned
September 27, 2006 – Cole A. Giller, MD PhD
Letters from Our Readers
September 27, 2006
A Worry-Free Way to Support Nonprofits?
September 27, 2006 – Emma Johnson
Message from the Editor
September 27, 2006
Doctor, What Should I Do?
September 27, 2006 – Marc Silver
Web Exclusive: Corporations Unite Against Cancer
September 27, 2006 – Elizabeth Whittington
Web Exclusive: What Parents Can Do
September 27, 2006 – Elizabeth Whittington
Web Exclusive: A Lion in the House
September 27, 2006 – Marc Silver
Multiple Myeloma & Leukemia
September 27, 2006 – Elizabeth Whittington
Coping
September 27, 2006 – Christopher Schultz
Legal Rights as a Survivor
September 27, 2006
Bookshelf
September 27, 2006 – Kathy LaTour
House Call
September 27, 2006 – Aman Buzdar
Mitigating Litigation
September 27, 2006 – Elizabeth Whittington
Cancer with a Known Cause
September 27, 2006 – Elizabeth Whittington
Cure Becomes Less Risky
September 27, 2006 – Alice McCarthy
Classifying & Clarifying MDS
September 27, 2006 – Elizabeth Whittington
When the Choice Is Not Cure
September 27, 2006 – Marc Silver
The Scoring System
September 27, 2006
Do Women Under 50 Need Mammograms?
September 27, 2006 – Beverly A. Caley
Currently Viewing
Watch It or Treat It?
September 27, 2006 – Beverly A. Caley
Creating a Dragon Boat Team
September 27, 2006 – Elizabeth Whittington
Arms in Motion
September 27, 2006 – Elizabeth Whittington
Job-Searching Hints for Survivors
September 27, 2006 – Elizabeth Whittington
Working Through Caregiver Grief
September 27, 2006 – Elizabeth Whittington
Fatal Fibers
September 27, 2006 – Katy Human
People & Places
September 27, 2006 – Elizabeth Whittington
Back in Action After DCIS
September 27, 2006 – Nancy Reuben Greenfield
Getting the Care You Deserve
September 27, 2006 – Stacy Beller Stryer
Treatment Boost for MDS
September 27, 2006 – Alice McCarthy
Power to the Patient
September 27, 2006 – Marc Silver
In Situ Breast Cancer: Is It Really Cancer?
September 27, 2006 – Beverly A. Caley
The Shadow Survivors
September 27, 2006 – Jo Cavallo
Taming the Dragon
September 27, 2006 – Elizabeth Whittington
The Choice to Work
September 27, 2006 – Elizabeth Whittington
A Waste of Taste
September 27, 2006 – Elizabeth Whittington
A Cunning Predator
September 27, 2006 – Katy Human
Lessons Learned
September 27, 2006 – Cole A. Giller, MD PhD
Letters from Our Readers
September 27, 2006
A Worry-Free Way to Support Nonprofits?
September 27, 2006 – Emma Johnson
Message from the Editor
September 27, 2006

Watch It or Treat It?

Many experts consider lobular carcinoma in situ, LCIS, to be a precursor to invasive breast cancer, but there is still debate over the best treatment including surgery and prevention with tamoxifen or Evista.

BY Beverly A. Caley
PUBLISHED September 27, 2006

Although LCIS shares the phrase “carcinoma in situ” with DCIS, these cells are usually not as severely abnormal as those classified as DCIS. Some experts think it should be renamed to more clearly indicate that these abnormal cells are benign.

A diagnosis of LCIS does mean, though, that a woman has a higher risk of getting invasive breast cancer later in life, and some experts now consider LCIS to be a true precursor to invasive cancer. An analysis of existing data published earlier this year in Cancer found that LCIS may signal the early stages of invasive disease.

Because of the multifocal nature of LCIS, the cancer could be in either breast, although it is slightly more likely to occur in the same breast as the LCIS. The number of LCIS cases has more than doubled since 1980, and because it rarely has any symptoms and there is no test to discover it, LCIS is almost always discovered incidentally during a biopsy of another lesion. A pathology second opinion may be appropriate since LCIS can be a difficult condition to diagnose.

Previous wisdom called for surgical removal of the affected breast, but it is now known that the presence of LCIS in one breast increases the risk of cancer in both breasts. Although the current recommendation for most women with LCIS is to watch and wait, some researchers think bilateral mastectomy should be discussed with women who have LCIS and a family history of breast cancer in a parent, child or sibling. Other doctors say this is an overly aggressive approach.

Treatment with tamoxifen is a non-surgical option for decreasing the risk of invasive breast cancer after LCIS. In the Breast Cancer Prevention P-1 trial, which involved 13,388 women with LCIS considered at high risk of invasive cancer, tamoxifen decreased the risk of invasive breast cancer by half. The STAR trial, which compared tamoxifen with the osteoporosis drug Evista, found that while Evista may be a good option for women at high risk of invasive breast cancer, the drug did not lower the risk of noninvasive breast cancer, including LCIS. Both Evista and tamoxifen carry side effects, such as blood clots and heart problems, so patients must consider both the benefits as well as the risks of these preventive agents. 

Continue the conversation on CURE’s forum. >>
Talk about this article with other patients, caregivers, and advocates in the CURE discussion group.

Related Articles

1
×

Sign In

Not a member? Sign up now!
×

Sign Up

Are you a member? Please Log In