LCIS-New diagnosis

loriio

Hello all.  I was diagnosed with LCIS on March 1st by a stereotactic biopsy.  I am meeting with the breast surgeon this Wednesday to discuss the next step.  I am not sure if I will need an additional biopsy or not.  I feel stuck in the middle.  I read online that it's actually not breast cancer, but it's not benign either.  I am a tell-me-what's-wrong-so-I-can-fix-it kind of person and this is not that kind of diagnosis.  I am, at this point, just needing to vent to someone that's been through it.  I realize everyone has a risk of breast cancer.  Everyone needs to be diligent, so I'm not completely freaking out about this diagnosis.  I just needed to get these thoughts out there in the world to get it off my chest (no pun intended).  I met with the breast surgeon before my stereotactic biopsy and I really liked her.  She is kind, but straight-forward.  I haven't seen her since the LCIS diagnois so I'm curious what she will say about it.  Wish me luck!

leaf

Best wishes, loriio!   Almost everything with LCIS is controversial.

Most, but not all, docs at this point will recommend either an excisional (i.e. surgical) biopsy to help make sure there is nothing worse going on in the area or BPMs (if you are sure you want them at this point.)  (About 20% of the time women are upgraded to DCIS or invasive.) 

They would be doing the excision (or mastectomies) NOT to remove the LCIS, but to make sure there isn't something worse (DCIS or invasive) going on in the vicinity.  They can't 'remove all the LCIS' because they can't  reliably tell where it is without biopsing it and looking at it under the microscope.  LCIS is often multifocal- meaning its in multiple places in one breast - and often bilateral - meaning it occurs in both breasts.  When LCIS women go on to get breast cancer in the future, the breast cancer is usually in places that look perfectly normal on imaging.  So very often, but not always, the LCIS seems to be a 'marker for increased risk'.  In most, but not all cases, they do NOT think that LCIS directly turns into invasive, but 'in a small number of cases' it probably does.

There are about 7 x fewer LCIS women than DCIS women.  So there aren't many women to study.  LCIS confers a risk of ROUGHLY 30-40% lifetime risk (at least if you don't have a horrible family history of bc or ovarian cancer), so  probably the majority of LCIS women NEVER go on to get breast cancer.   But this lifetime risk number is pretty uncertain, as in all things LCIS.  There is a study by Chuba that looked at long term breast cancer risk of LCIS women.  I'd give you the citation, but I still can't get Pubmed to work.  Don't know what's up with Pubmed the last 2 days, or if there's something wrong with me/my computer.

After the excision, if you have nothing  worse than LCIS, there is no rush about taking your time to decide what treatment choice is best for you.

carol57

Here is the Chuba study link:

http://www.ncbi.nlm.nih.gov/pubmed/16110014 

RESULT: The incidence of IBC increased over time from diagnosis of LCIS, with 7.1% +/- 0.5% incidence of IBC at 10 years. IBCs detected after partial mastectomy occurred in either breast (46% ipsilateral and 54% contralateral); however, after mastectomy, most IBCs were contralateral (94.7%). IBCs occurring after LCIS more often represented invasive lobular histology (23.1%) compared with primary IBCs (6.5%). The standardized incidence ratio (the ratio of observed to expected cases) for developing IBC was 2.4 (95% CI, 2.1 to 2.6) adjusted for age and year of diagnosis.
CONCLUSION:
LCIS is associated with increased risk of subsequent invasive disease, with equal predisposition in either breast. The minimum risk of developing IBC after LCIS is 7.1% at 10 years. 

leaf

Thanks  so much, Carol! Ah ha!  The problem was that I shut off cookies.  Thank you so much again, Carol!