LCIS/"lobular cancerisation"

geebung

I had a mastectomy/SNB for DCIS a few months ago. I have been reading a lot about LCIS being in the high risk category. My path report says: "Occasional lobular cancerisation is present". Is this the same as LCIS?

nash

Lobular cancerization seems to be different from LCIS. I found this via google, hope the link works:


http://books.google.com/books?id=tTBLHhx...T9MBQmbgjpwfumw

leaf

No, I don't think so.
Q. What is meant by "cancerization of lobules?" The pathology reads "Ductal carcinoma in-situ, comedo and cribiform types, multifocal with cancerization of lobules. "What histology code should be assigned?

A. "Cancerization of lobules" refers to extension into the lobules and should be ignored when coding. The term "type" indicates majority of tumor. No combination code exists for comedo and cribiform. Code ductal CA in situ, comedo carcinoma, cribiform (8501/2) higher code. http://fcds.med.miami.edu/memos/99-0708memo.html

CANCERIZATION OF THE LOBULES
Cancerization of lobules and atypical ductal hyperplasia adjacent to ductal carcinoma in situ of the breast.

Goldstein NS, Lacerna M, Vicini F.

Department of Anatomic Pathology, William Beaumont Hospital, Royal Oak, Michigan 48073, USA.

Am J Clin Pathol 1998 Sep;110(3):357-67 Abstract quote

Recurrent carcinoma develops in approximately 10% of patients with ductal carcinoma in situ (DCIS) of the breast treated with local excision and radiation therapy. Cancerization of lobules (COL) and atypical ductal hyperplasia (ADH)frequently occur at the edge of DCIS.

We postulated that recurrent carcinoma is associated with ADH or COL near the DCIS excision margin, and the amount of DCIS left in the breast may be too large for eradication by radiation therapy.

To identify histologic features associated with recurrence, we retrospectively studied specimens of 94 patients with DCIS treated by local excision and radiation. We analyzed the rim of tissue near the final margin for the amount of COL, ADH, and DCIS. During a median follow-up of 78 months, local recurrence developed in 9 patients. COL or ADH with DCIS near the final margin was associated with recurrence; the strongest relationship was with recurrences in the same site as the lumpectomy bed. DCIS with ADH was significantly associated with recurrence in the low-grade DCIS group; DCIS with COL was associated with recurrence in the high-grade group. Other features were not associated with outcome.

We believe that ADH composed of cells identified as those of DCIS should be considered part of the DCIS lesion. DCIS may be inadequately excised if ADH and DCIS or COL and DCIS are near the margin. http://www.thedoctorsdoctor.com/diseases/dcis.htm

If it helps any, I probably have somewhat of the opposite diagnosis. I have "LCIS with pagetoid spread into the ducts", with ALH.

geebung

Thanks so much leaf for all that info. It initially sounded a bit scary but now it doesn't seem to be anything to be concerned about. The jargon can be a worry at times.

Best wishes

Geebung

mbordo

Geebung-

I had this in my path report, as well. I asked Dr. Lagios (who is a pathologist who has studied DCIS for many years), and the findings are not particularly significant. My hospital *did* have to send my path out for detailed analysis to rule out LCIS. Through immunohisto chemical-staining they could tell they were ductal cells found in the lobe. Not sure if cells are created in the lobe, then move to their final location, or if they were ductal cells that migrated to the lobe?? Doesn't affect treatment or prognosis - but for diagnostic purposes you need to know if you have a ductal or lobular issue - or both (which can happen!)...

I had a fairly large amount of low and mid-grade DCIS.

Mary