PLCIS

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nala24
nala24 Member Posts: 38
edited June 2014 in LCIS (Lobular Carcinoma In Situ)
PLCIS
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  • nala24
    nala24 Member Posts: 38
    edited June 2008

    Hi,

    I was on this board a few weeks ago after an LCIS diagnosis that came from a MRI guided core biopsy.  A week later the diagnosis changed to DCIS and I had a lumpectomy on 5/22 and the pathology showed classic and pleomorphic LCIS (no DCIS).  I am having a re-excision on 6/16 to remove the the "more agressive" PCLIS from the margins and get more tissue samples.  I asked the surgeon what my options are if the margins are still not clean after the re-excision, he said I probably could move on to Radiation and Tamox since he has to treat the original DCIS diagnosis but it appears that DCIS is not in the margins.  Has anyone had a re-excision for PCLIS?  Does radiation have any effect on LCIS?

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  • Misty3
    Misty3 Member Posts: 154
    edited June 2008

    Hi Nala,  I don't have an answer to your question but I'm sure someone will come along with some info.

    Just wanted to say hi and welcome.  I have not seen your name here before--although I am fairly new. 

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  • Misty3
    Misty3 Member Posts: 154
    edited June 2008

    ps--my limited knowledge is that PLCIS is treated a little more aggressively that LCIS ( really no rx for LCIS except prevention).  I do not think radiation is appropriate for LCIS ( not cancer supposedly ) nor is it used for LCIS.

    DCIS as you know, is the dominant lesion and is rx with surgery and radiation.

    I'm sure leaf will add much more to this.

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  • Anonymous
    Anonymous Member Posts: 1,376
    edited June 2008

    nala---- since LCIS is non-invasive, it does not require radiation.  It does not require clean margins as LCIS is generally believed to be multifocal, multicentric and bilateral--meaning it could be everywhere and anywhere throughout both breasts, so in order to "get it all" theoretically you 'd have to have a bilateral mastectomy. Since they also diagnosed you with DCIS, it "trumps" the LCIS and the focus of your treatment would be for the DCIS. I think breast conserving treatment (lumpectomy) is still an option even if you have LCIS along with it, unless the DCIS is widespread, which might necessitate a mastectomy. The radiation would be targeted at the area of DCIS. Then they probably would put you on either tamoxifen or an AI depending on your menopausal status and monitor you closely.

    Anne 

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  • leaf
    leaf Member Posts: 8,188
    edited June 2008

    Your treatment will probably depend on what your 'worst' diagnosis on final pathology report reads. (You may or may not want to get your slides reread.)





    If they find any invasive, then most will go mast, or (lump+rads) ,+/- chemo (with some variation) with or without other stuff, depending on the characteristics of the cancer.





    If DCIS, then depending maybe( lump + rads), or mast.





    If its LCIS and nothing worse, then you have the usual: screening +/- hormonal, or mast.





    If its PLCIS, then I don't think they've established treatment: PLCIS is more unusual than LCIS and nothing worse.I'm not sure if they've even established the 'natural history' of PLCIS. I gather that PLCIS is a 'newly established' pathological category. It sounds like there are often 'reclassifications' after other pathologists read the slides and/or more tests are done. http://www.ingentaconnect.com/content/ben/cg/2006/ 00000007/00000008/art00006;jsessionid=ldlcb7cpl73b.alexandra



    These are the only 2 abstracts I could find about treating LCIS with radiation. Its certainly not a standard treatment.

    http://www.ncbi.nlm.nih.gov/pubmed/15691636

    http://www.ncbi.nlm.nih.gov/pubmed/9769400





    These are the only abstracts I could find when I did a Pubmed search for 'PLCIS + treatment' . Pubmed is very sensitive to search terms, so you may be able to find more.





    http://www.ncbi.nlm.nih.gov/pubmed/12379750

    http://www.ncbi.nlm.nih.gov/pubmed/11117786





    Other related abstracts include:

    http://www.ncbi.nlm.nih.gov/pubmed/15957152

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  • nash
    nash Member Posts: 2,600
    edited June 2008

    Nala, I have PLCIS and pleomorphic ILC. Here's what I've been told and what I've read:

    *like awb said, radiation has no effect on PLCIS or LCIS.

    *PLCIS is sometimes difficult to distinguish from DCIS--you might want to get a second path opinion

    *my PILC was removed, but not my PLCIS. At first the surgeon, onc and tumor board told me I'd have to have bilat mast b/c of the remaining PLCIS being more aggressive than LCIS. Then they decided I was more at risk from mets from the PILC and that I could just go with the lumpectomy and have semiannual breast imaging.

    So my advice to you would be to get the question of whether you have DCIS or not sorted around first, and then move on from there. 

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