By Jenny Powers
GLASGOW, Scotland -- March 24, 2014 -- Lobular carcinoma in situ (LCIS) is not always indolent, and may warrant aggressive treatment, according to results of a retrospective analysis presented at the 9th European Breast Cancer Conference (EBCC9). Local recurrence is likely to occur within 7 years -- especially in women who received breast-conserving surgery.
“The major concern…is the risk of subsequent invasive carcinoma,” commented lead author Bruno Cutuli, MD, Courlancy Polyclinic, Reims, France, speaking here on March 20. “The optimal treatment is still debated.”
Dr. Cutuli and colleagues examined LCIS in 200 patients treated with either lumpectomy/ breast conserving surgery (BCS), BCS plus radiotherapy, or mastectomy. At a median follow-up of 7 years, the patients who received mastectomy showed no local recurrence, but there was local recurrence in the BCS group (17%) and BCS/RT group (16%). In all, 64% of the recurrences were invasive, and 36% were in situ.
At Courlancy Polyclinic, BCS plus radiotherapy is the standard, Dr. Cutui noted. Over the median 12 years of follow-up, just 3 cases of local recurrence have occurred. “Further studies should be undertaken to evaluate the potential benefit of radiotherapy [in LCIS], especially in the aggressive subtypes,” he commented.
“LCIS represents just 1% to 2% of all breast cancer, but the incidence is increasing, especially in middle-aged women,” Dr. Cutui added. “Some aggressive subtypes have recently been identified.”
The median age in this study was 52 years, and 44% of the women were postmenopausal. A first- or second-degree family history of breast cancer was present in 30% of patients. In all, 59% of the patients had single LCIS, and 41% had multiple foci.
LCIS is often identified as an incidental finding made around that of fibroadenomas or cysts. In this study, LCIS was discovered by clinical symptoms in 22% of women, by routine screening with mammography or ultrasound in 72%, and incidentally in 7% of patients.
[Presentation title: Lobular Carcinoma in Situ (LCIS): Long-Term Outcome According to Treatment Analysis of 200 Cases. Abstract #263]
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