Lobular carcinoma in situ (LCIS)
This information is about lobular carcinoma in situ (LCIS). We hope the information answers your questions. If you have any further questions, you can ask your doctor or nurse at the hospital where you're having treatment.
Lobular carcinoma in situ (also called lobular neoplasia) is not a cancer. It means there are changes in the cells lining the lobes (see diagram below) where milk is made in the breast.
These changes indicate that a woman has a higher risk of developing breast cancer later in life. But even so, most women with LCIS never develop breast cancer. A woman’s risk of developing cancer is similar in both breasts, no matter which breast LCIS is found in. Some women have LCIS in both breasts.
LCIS is more common in women who have not reached their menopause.
LCIS doesn't show up on a mammogram (breast x-ray) and doesn’t cause any symptoms. It's usually discovered by chance when a sample of breast tissue is taken (biopsy) or you have a breast lump removed for another reason.
If you have LCIS diagnosed after a needle biopsy (when the doctor uses a needle to take cells or tissue), you may need some more tissue removed. This is a small operation called an excision biopsy. It’s usually done to make sure there are no cancer cells in the area.
The surgeon will remove the tissue under a local or general anaesthetic. You can usually have this done as day surgery. The tissue that has been removed is then examined under a microscope.
If you have LCIS you won’t need any treatment. Most women with LCIS don't develop breast cancer so never need treatment. You’ll have regular monitoring to make sure that if a cancer does develop, it will be picked up early.
Treatment for early breast cancer is usually very successful. Your doctor and breast care nurse will explain how you will be followed up depending on your situation.
Monitoring or screening
Doctors usually recommend women with LCIS have:
Breast examinations every 6-12 months at the breast clinic
Mammograms every 1-2 years.
Although you’ll have regular checks, it’s important to carry on being aware of any changes in how your breasts look and feel at different times. If you notice anything out of the usual for you, tell your doctor or breast care nurse as soon as possible.
Rarely, a woman with LCIS may decide to have both breasts removed (bilateral mastectomy). This may be when a woman also has a strong family history of breast cancer, or is extremely anxious about her risk of developing breast cancer.
Research - clinical trials
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Women with LCIS may be invited to take part in a clinical trial that’s looking at reducing breast cancer risk. This will depend on the trials that are going on at the time.
Results of a previous trial have shown that a hormonal therapy drug called tamoxifen, which is used to treat breast cancer, can reduce the risk of breast cancer in women with LCIS. But it's not clear if the possible risks and side effects of tamoxifen outweigh this reduction in risk.
Another trial called IBIS2 looked at whether another hormonal therapy, called anastrozole, reduces the risk of breast cancer in post-menopausal women, and included women with LCIS. It’s now finished and the results won’t be available for a few years.
It’s natural to feel worried if you’re told that your risk of developing breast cancer is increased. But LCIS is not a cancer and most women with it will never develop breast cancer.
It can be reassuring to know that you will have regular checks from your breast team. Your doctor and nurse are also there to give you support. Let them know about any concerns or if you’re often worrying about your risk.
This information has been compiled using information from a number of reliable sources, including:
National Institute for Health and Clinical Excellence (NICE). Early and localised breast cancer: Diagnosis and treatment. February 2009.
Bland, Copeland. The Breast: Comprehensive Management of Benign and Malignant Disease. 4th edition. 2009. Saunders.
Ansquer et al. Risk of invasive breast cancer after lobular intra-epithelial neoplasia: review of the literature.
Eur J Surg Oncol. 2010. 36(7):604-9.
With thanks to Professor Stephen Johnston, Consultant Medical Oncologist, and the people affected by cancer who reviewed this information.