LCIS

[Eege]

I was just recently diagnosed with lobular carcinoma in situ and the surgeon is really pushing for a bilateral mastectomy and is almost set on the fact that I will allow this.  I have no first degree links and at this point they haven't even run any estrogen receptor tests.  Everything I read says this is a dramatic action for a problem that may or may not develop into a cancer. Is it normal for a surgeon to push so hard for a treatment.  I meet with the oncologist on 3/17 so am waiting to see what he thinks but am a bit miffed that this is being the only option this Dr. is able to see. Any one else out there that has gone through this and how was their case handled.

[CCF-RN,MSN-JS]

Dear Eege, Deciding how to treat lobular carcinoma in situ (LCIS) can be complicated because the condition itself is not cancerous and the majority of people with LCIS do not ever develop cancer; yet, it is known that they have a higher risk of developing cancer in the future. Typically, people with LCIS are followed more closely, increasing surveillance for breast cancer in order to identify breast cancer at the earliest, most treatable stage if it does occur.  Studies have also shown that taking the hormone tamoxifen reduces the risk of developing breast cancer in women who have been diagnosed with LCIS.

Bilateral prophylactic mastectomy without axillary node dissection is sometimes considered as an alternative approach for women at high risk for breast cancer. However, many breast surgeons now consider this to be an overly aggressive approach.

The oncologist will be able to discuss each of these options with you in more detail, and help to guide your treatment decision to the one most appropriate for your specific situation.

[Eege]

Hi Kinglet,
I hope what my oncologist has told me helps you some too.  The least I can do is the medical professional breast examine and diagnostic xray every 6 months.  Next and considered one better would be taking tamoxifen but they can't tell me if my risk factor would change as I had an endrometrial ablation 2 yrs ago and one of the risk factors is endrometrial or uterine cancer.  The extreme would be the bilateral and he will only recommend that if the women just can't deal with ever having a cancer form. He told me my risk is 1% per year.  My big concern with the tamoxifen was having my daughter here alone while my hubby is deployed so we have chosen to do the follow up exams and wait until he is home before we start over thinking this.  My surgeon while an excellent surgeon should stick to surgery and not scare tactics and at this point may not be my surgeon of choice in the future. The risk is the same for both breasts. Taking tamoxifen will reduce your lifetime risk to 1/2% per year and then again he said I was right when I said I may never develope a cancer and may die with LCIS never being anything more than that.  I live in Montana and breast clinics are nil but before anyone cuts on me again I will definitely look for second opinions.  I'm looking forward to what you find out.

[kinglet]

Hi EEge,

I have just been similarly diagnosed.  As I understand it, LCIS is not cancer but it can develop into cancer 20-30% chance over 10-15 years.  I am meeting with a surgeon as well in April and I was told in my case it is not urgent but a lumpectomy, after an MRI to confirm and evaluate extent, would be the best course of action. I'll post my findings as I discover them if you'd like.  It would be great if you were able to do the same.