Lobular carcinoma in situ, or LCIS for short according to Abbreviation Finder, is a growth of the mammary gland that can spread to the milk ducts. Lobular carcinoma in situ is a non-invasive carcinoma. In situ means in place, meaning it will not grow into surrounding tissue. However, lobular carcinoma in situ is a risk factor for the development of breast cancer. The disease is to be distinguished from ductal carcinoma in situ.
What is lobular carcinoma in situ?
A lobular carcinoma in situ is an early form or a so-called risk marker of breast cancer. LCIS - lobular carcinoma in situ (Latin term) – is a non-invasive carcinoma that occurs primarily in the area of the mammary gland and milk ducts.
Although rare, lobular carcinoma in situ can develop into invasive carcinoma. Lobular carcinoma in situ is often multicentric, meaning it is located in different areas of the breast.
However, LCIS can also occur in both breasts at the same time. A lobular carcinoma in situ is usually discovered by accident. Because LCIS does not form microcalcifications, it cannot be detected on a mammogram.
The causes of lobular carcinoma in situ are unknown. However, LCIS often occurs in families with a history of breast cancer. It could also be observed that more women were affected who only started menopause very late. However, this has not been scientifically proven to date.
Symptoms, Ailments & Signs
A lobular carcinoma in situ usually does not cause any clear symptoms. Typical breast cancer symptoms such as lumps or pain in the breast only appear when the carcinoma metastasizes. If the course is severe, other symptoms appear, such as inflammation and bleeding in the nipple area, hardening and an increasing feeling of illness.
Externally, a lobular carcinoma in situ can be recognized by the palpable growth in the chest area. Depending on the size and location of the carcinoma, swelling or even a lump under the skin can occasionally be seen. The knots reach a size of one to two centimeters. They are usually firm, cannot be moved and do not cause pain when touched.
Occasionally, swelling next to the breastbone, in the armpit or in the area of the collarbone can accompany the formation of lumps in the breast. If the course is severe, the nipple may also retract. This is usually accompanied by skin changes, such as inflammation, redness or enlarged pores. If the lobular carcinoma in situ is treated early, metastasis can be reliably avoided and any side effects quickly disappear.
Diagnosis & History
Lobular carcinoma in situ is usually discovered incidentally. Lobular carcinoma in situ does not form microcalcifications, so it cannot be imaged with mammography. Furthermore, a lobular carcinoma in situ is neither visible nor palpable from the outside.
It is usually used as part of preventive medical check-ups, e.g. B. a breast screening and subsequent biopsy discovered. A lobular carcinoma in situ is diagnosed by a pathologist. In a biopsy, tissue is removed from the mammary gland, which is then examined histologically.
As with all carcinomas, the course should be evaluated carefully. As long as a lobular carcinoma is present in situ, i.e. a non-invasive carcinoma, there are no reasons for a shorter life span or for a worsening of the health. Since LCIS does not cause any symptoms, those affected usually lead a completely normal life.
In most cases, this condition does not cause any particular symptoms or pain. For this reason, this complaint is only diagnosed relatively late and usually only by chance. Since this is a form of cancer, the further course of the disease depends very much on the severity of the tumor.
If this has already formed metastases, there is usually no longer a positive course of the disease and thus a significantly reduced life expectancy for the patient. Only in rare cases does the disease cause pain in the breasts or nipples. These can also be bloody or emit a secretion. As a rule, however, the complaints are relatively rare.
As a rule, this tumor can be treated relatively well if treatment begins early. However, success also depends to a large extent on the patient’s state of health. Other complaints or complications usually do not occur. If left untreated, it can also lead to breast cancer. As a rule, patients also need psychological treatment.
When should you go to the doctor?
Changes and abnormalities in the nipples should be presented to a doctor. If there is bleeding, the formation of pus or a feeling of inflammation in the nipples, a doctor is needed. If you have a fever, general malaise, or chest pain, you should see a doctor. If there is swelling of the breast, a feeling of pressure or a feeling of tension in the breast, a doctor’s visit is necessary. If lumps or other irregularities are palpable in the breast, they should be shown to a doctor. A doctor should also be consulted if symptoms worsen or spread.
A special feature of lobular carcinoma in situ is the non-displaceability of the palpable lumps in the breast. If you feel pain when you touch your chest, this is considered a concern. If everyday movements or locomotion can no longer be carried out without symptoms, a doctor should be consulted. Since metastases can form, early treatment of lobular carcinoma in situ is essential for survival. In the case of psychological problems, behavioral problems or changes in personality, a visit to the doctor is also advisable. The person affected needs therapeutic support to cope with the disease.
Treatment & Therapy
Treatment of lobular carcinoma in situ begins with a biopsy. Hormone therapy is usually then started to reduce the risk of it developing into invasive cancer.
A few years ago, a bilateral mastectomy (removal of the breast) was performed as a prophylactic measure. This was done to prevent breast cancer from occurring. Today we know that a lobular carcinoma in situ only very rarely turns into an invasive carcinoma, i.e. breast cancer. Mastectomy is only recommended for those who are at high risk of developing breast cancer.
If a lobular carcinoma has been diagnosed in situ, close histological and mammographic control examinations should be carried out. Psychological support should also be provided. The word carcinoma has the colloquial meaning of “cancer” and evokes horror and despair in most of those affected. Because of this, talk therapy with a trained therapist is highly recommended.
Outlook & Forecast
The prognosis of lobular carcinoma in situ depends on various factors. There are three subtypes, each associated with a different risk of developing invasive breast cancer. If breast cancer does not develop, the prognosis for lobular carcinoma in situ is extremely favorable because it does not leave its region but remains in place in the tissues and shows no invasive tendencies. For this reason, in many cases, close monitoring of the affected breast is sufficient.
However, the lack of visualization in the tissue using conventional imaging methods can have an unfavorable effect on the prognosis. This form of carcinoma in the glandular lobules cannot be felt in the breast either. It can therefore develop unnoticed over a very long period of time before it is even discovered. In addition, it often affects multiple areas of the breast, often both breasts, so it can not be completely removed without a mastectomy when that is advised.
Of the three types of lobular carcinoma in situ, the extended type is associated with a slightly poorer prognosis for developing invasive cancer. The prognosis then depends on the completeness of the tissue removal and the regularity of the controls.
No measures can be taken to prevent lobular carcinoma in situ. At this point, only general measures can be taken, e.g. B. a balanced and healthy diet, avoidance of obesity.
There are currently no imaging methods to visualize lobular carcinoma in situ. Furthermore, there are no tumor markers in blood tests that could give an indication of this disease.
Women with a high risk factor for breast cancer should take regular check-ups and breast screening. If a lobular carcinoma was discovered in situ, then in this case preventive measures can be taken to avoid developing breast cancer.
Follow-up care is a central element in the therapy of carcinomas. In this way, the recurrence of a disease should be detected as early as possible, from which doctors promise advantages in the context of therapy. After an operation, radiation or ablation, there is always a constant risk of a tumor recurring.
In addition, aftercare is also about offering everyday support. Patients often complain about psychological problems after an operation and need help in everyday life. A carcinoma cannot always be completely removed. Then it is not uncommon for long-term treatment to be necessary. Daily drug treatment remains unavoidable.
Patients usually attend a follow-up examination once every quarter or six months. Which rhythm is indicated depends on the type of carcinoma, the symptoms and the tumor stage at the time of initial diagnosis. The breaks between appointments are usually longer if no new growth has been detected after two to three years. The family doctor or a clinic is responsible for aftercare.
Essential elements of an appointment are an intensive discussion and a physical check-up. Ultrasound examinations and other imaging procedures are carried out regularly. Blood tests to determine specific markers are also carried out.
You can do that yourself
The lobular carcinoma in situ usually does not cause any typical symptoms, so that the patients only find out about it by chance during a medical examination. But then the shock for many of those affected is deep when they are diagnosed with carcinoma. Nevertheless, it is important that patients remain calm and realize that the disease only relatively rarely leads to the development of breast cancer.
Adequate monitoring of the developmental status of the carcinoma is paramount. For this purpose, the patients take advantage of all medical appointments and examination offers. It is usually necessary to visit various doctors and medical institutions. In their own interest, those affected try to reduce psychological stress as much as possible. Mental balance has a beneficial effect on physical health. The patients follow a healthy lifestyle and turn to the attending physician for all questions and concerns.
In some cases, however, the disease leads to severe psychological impairments, such as anxiety attacks or depressive phases. Then the doctor refers the affected person to a psychotherapist, who supports the women in dealing with the carcinoma. This usually improves the quality of life of those affected and makes it easier to cope with the challenge posed by the disease.