LCIS and Very Dense Breasts

I am 54 also, was diagnosed with LCIS at 51.  I asked my radiologist on my last biopsy, and he said I had 'dense, but not very dense, breasts." A major university opined that I 'shouldn't have MRIs, even a baseline' because of my extensive scar tissue from my solitary excision.

LCIS is an unusual condition, so it is difficult to get significant findings.  I read in an Up To Date (a subscription service that surveys several hundred journals)  opines that there was some speculation that that the risk factors for LCIS were similar to that of IDC: family history and breast biopsy.  

For women already diagnosed with LCIS, Up to Date said one study thought family history was a risk factor, but a re-analysis of the data showed that family history was only important if the diagnosis of LCIS was made before the age of 40. Others have found that family history had no bearing on the subsequent risk for invasive cancer for LCIS women.

Pleomorphic LCIS (PLCIS) may be in a different category, according to Up To Date. 

I have a weak family history, and had no previous breast biopsies before my LCIS was discovered. 

Interestingly, the Up to date now opines that in subgroup studies of the 3 largest prospective,randomized, double blind studies of high risk women, all of which enrolled LCIS women, that the LCIS women who took tamoxifen did have a lower incidence of invasive breast cancer. (The tamoxifen women had about a 40% lower incidence of breast cancer.)

HOWEVER,  the tamoxifen LCIS women did not have ANY survival advantage compared to the LCIS  women who used surveillance alone. 

I agree with Anne; I have not heard of an association between LCIS and breast density, and I have heard that tamoxifen in general may make breast tissue less dense.

Hi Mykidsmom -

Well as I have been told repeadily I HAVE EXTREMELY DENSE breasts,  with an extremely complex parenchymal pattern,  and both breast (right worse) are extremely cystic - I was DX with LCIS, ALH along with the ILC in L -   R breast just this week ADH and low grade DCIS. So I don't know either if they are related -but thats my info.

Hi Misty!  I am not sure who is doing any current research on LCIS - as far as knowing its natural history, treatment, etc.

I am guessing that Li et al are interested in the epidemiology of in situ cancers-most of the papers I've seen from that group are on both DCIS and LCIS.

Port et al at Sloan Kettering did the MRI study.  

I will try to look into this further - I just got DSL, so I'm trying to set up my new computer, and all that entails. 

Well, I've heard of Sanford Barsky before.  He's interested in how cancer starts...http://www.cbcrp.org/RESEARCH/PageGrant.asp?grant_id=1836

Looks like he's now in Ohio. https://pro.osu.edu/profiles/barsky.3/

He's not the first author on this paper on IBC,but his name is on it. (Probably done in his group.) http://ajp.amjpathol.org/cgi/content/abstract/ajpath.2008.071214v1

He does seem to support the idea that stem cells cause cancer. http://www.economist.com/science/displaystory.cfm?story_id=11487414

http://www.economist.com/science/displaystory.cfm?story_id=11487414 

They don't cite any literature on this, but its written by 2 PhDs.  You don't have many doubts what their opinion is!  http://www.center4research.org/wmnshlth/2006/dcis10-06.html

Maybe this is a co-worker with Li et al in Seattle.http://www.asbd.org/images/LCIS%20-%20Anderson.pdf.

Here's a clinical study in Europe on LCIS genetics. http://clinicaltrials.gov/ct2/show/NCT00536718

Imaging + LCIS at the Mayo, by invitation only.http://clinicaltrials.gov/ct2/show/NCT00620087

Here's a study of invasive BC when associated with LCIS.

http://clinicaltrials.gov/ct2/show/NCT00581750

And another (looks like this is purely epidemiological). http://clinicaltrials.gov/ct2/show/NCT00146536

That's something, anyways. 

P.S. Sorry about the font/style/etc. I don't know why I have shrinking font sizes in my post.  When I write them they are normal.  I have a Mac, so maybe this website is not optimized for that. 

leaf--OMG--this will keep me busy and out of trouble for awhile!!!!  Thank You so much for the information--and I thought I had read every article on LCIS ever written!!! lol! 

Misty 

ps-You'll be proud to know I am taking a graduate pharmacology course this semester. With each passing class, I gain a deeper appreciation for pharmacists and the difficult work they do to keep hospitals running and patients alive!

Leaf--thanks for in the info.  I'll mention it to my oncologist next visit--maybe he'll have me go for MBI instead of MRI. It's supposedly less expensive and has less false positive results, but it involves additional radiation which I like avoiding with MRI.  Oh well, every technology has it's downside,

Anne

Hi all, just thought that I would add....I was dx at age 43 with LCIS and DCIS and IDC.  Fibro cyctic disease seems to run in my family.  No bc family history, except for an aunt on my father's side, and she was dx at age 70.  I also had....very dense breasts.  Having dense tissue is just another hoop that you have to jump through to make sure nothing is going on in there, you know, it's like trying to find a needle in a haystack, but, they can't even find the haystack.  I have often wondered if there was a connection.  If I could have a do over, I would definitely have gotten breast mri's to make sure everything was clean.

Just diagnosed with LCIS in both breasts after an elective reduction and lift.  God works in mysterious ways.  I have had fibrocystic disease for MANY years (am 50 now).  Mammograms and sonograms were always tough to read.  Beasts have always been dense and lumpy.  Short answer to your question is "yes".  No family history of breast cancer.  I will see a specialist in Charlotte next week and then make some decisions after that visit.  Not freaked, just bummed.  This is not my first dance with cancer.  Have had melanoma twice before.  Destined to live life looking over my shoulder.  Any advice gladly welcome and taken.  I'd especially like to know if there are any specialists you all can recommend.  I am a New Englander originally and find the best medicne to be on the left and right coasts.  I'll go where the "good ones" are.  Happy and Healthy New Year to all!

Some people with LCIS on this site have been happy with Duke U.  (I've never been there as that is quite a distance from where I live.)

Karen is right on the money.   There is hardly anything about LCIS that is NOT controversial (including the name.)

I went to the nearest NCI certified cancer center, and was unhappy with their High Risk breast department.  I liked their genetics dept and other departments, though.  Everyone is different.

My bc was multi-focal - ILC and LCIS. Since I was 18 I was told I had very dense tissue. When I turned 40 I started having annual mammos. For the next 5 years a "clump" of dense tissue was continually mistaken as JUST dense tissue. Turns out that it wasn't dense tissue - it was a 3.9cm malignant tumor. I don't want to scare you girls, but had I known all that I do now...I would have insisted that the "clump" be biopsied at the time of my first mammo. I have recently read that dense tissue DOES put you at a greater risk of developing bc...in addition to the fact that it can be hard to "see through".

taraleec - I would request a biopsy. Again...don't want to scare you, but better safe than sorry.

LauraGTO - I'm sorry to hear about your ILC and LCIS.  Did you have a lumpectomy or mastectomy?  How are you doing now?  I'm trying to get into a different Dr. since my gynecologist and I can feel them but surgeon says he can't feel the lumps and mammo and ultrasound says dense breasts.  I know there's something there.  And to awb- No DCIS, I had LCIS with radial scar, sclerosing adenosis and intraductal hyperplasia and my ONC said my risk of it progressing further was at 40% and she strongly recommended radiation, so I did it.  But I didn't imagine something would happen with the opposite breast this soon.  I'm soooo stressed and confused.

taraleec---after googling "radial scar"  I found that it is generally thought to be a benign condition, but sometimes associated with ADH or DCIS, so perhaps that's why they recommended the radiation? (I'm NOT saying that is what it is, I'm just wondering, as everything I've read says no radiation for LCIS).  Have you had an MRI since you discovered the new lumps? Praying that it's nothing more serious and that you get good news soon.

Anne

Just wondered, is MRI more accurate than mammos and ultrasound?  My first and 2nd ultrasound didn't show a mass, when in fact I did have a mass the first time which was LCIS, and my 2nd was benign, I went back to my surgeon after my most recent mammogram and ultrasound, since it shows no mass, and he says he doesn't feel the lumps he doesn't see reason to go back in.(Although my gynec. can feel them)  I asked for an MRI, so it's to be scheduled.  Does anyone have experience when mammos and ultrasound didn't show mass, but MRI does?  I just can't get a grip on this LCIS.

taraleec-----MRI, US, and mammo all "see" things differently----they all have certain levels of accuracy, but really can't be compared to each other--it's like comparing apples to oranges. MRIs are reportedly better at detecting the invasive bc's, while mammos reportedly are better at detecting the non-invasive bc's, US are very good at telling if cysts are fluid or solid filled, for instance. That's why it's good to have different tests to be able to utilize to see the whole picture of what's going on. It's good you are going for the MRI--hopefully nothing more serious than the LCIS will be found. I go for my next MRI in March.

Anne