LCIS...again!

ldteacher

LCIS...again!

ldteacher

I have a history of LCIS on my right side so when calcifications showed up on my recent mammogram, I was not surprised to receive a diagnosis of LCIS now on the left side. Though I'm not surprised, I am a little disheartened. I know. It's a benign result. I am lucky and I do feel lucky. It's just a lot of procedures and waiting and worrying. Which made me wonder about two things. Are preliminary biopsies like the steriostatic biopsy an unnecessary step when LCIS is known to be present? In another words, with LCIS present, won't an excisional biopsy be recommended anyway? Why cut twice? Also have any of you with an LCIS diagnosis ever gone on to receive an "all clear" biopsy result? Does LCIS resolve? 

Thank you in advance for all comments. 

MelissaDallas

Idteacher, because of the nature of LCIS, I always figure they could pretty much stick a needle in either of my breasts anyplace and have about even odds of coming up with a piece of it. (Last time I had a biopsy I joked to the radiologist about this and told her to please try to avoid hitting any more of it:) Anyway, my guess is they'll still want to do another excisional to rule out invasive cancer, but you always have the option to decline and say you are comfortable with waiting and watching until your next check, if, in fact, you are. Last time I told her I would have been comfortable waiting on a stereotactic biopsy because it looked low risk, but since I was already there we went ahead. It did turn out to be a complex cyst that collapsed.

leaf

We don't know how LCIS causes people to have an increased risk of breast cancer.

 But they think that when LCIS 'goes bad' (when LCIS women go on to get DCIS or invasive breast cancer), that most of the time the LCIS itself does not become breast cancer.  So it doesn't really matter if you 'remove all the LCIS'.   It could be that some unidentified factor causes LCIS, and this unidentified factor also can subsequently cause an increased risk of breast cancer.  LCIS does not have to become worse breast cancer.  That's why LCIS is often referred to as a 'marker of increased risk' of breast cancer.  For the LCIS women who go on to get invasive breast cancer, this invasive breast cancer is sometimes, but not always have chromosome damage in common with the LCIS.

Association is not causation. So if A (LCIS) is associated with B (invasive breast cancer), that doesn't mean that A (LCIS) causes B ( invasive breast cancer).  Factor X could cause both A (LCIS) and B (invasive breast cancer).

For the people with LCIS who subsequently get invasive breast cancer, the subsequent invasive breast cancer sometimes/often happens not where the LCIS was located, but in places that previously looked totally normal in imaging.   

They <atypical ductal hyperplasia (ADH), atypical lobular hyperplasia (ALH),
flat epithelial atypia (FEA), and lobular carcinoma in situ (LCIS)>

are generally not considered premalignant lesions, as the cancers
that subsequently develop may occur anywhere in the breasts, not
necessarily at the site of the atypia. 

http://www.uptodate.com/contents/atypia-and-lobula...

I vote that LCIS is a weird condition.