Erschienen in:
27.09.2019 | Breast Oncology
Why Breast Cancer Risk Models Fail: The Case of Lobular Carcinoma In Situ
verfasst von:
David M. Euhus, MD
Erschienen in:
Annals of Surgical Oncology
|
Ausgabe 3/2020
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Excerpt
The first photomicrograph demonstrating lobular acini distended with bland, discohesive cells was published in 1908.
1 The condition was named lobular carcinoma in situ (LCIS) in 1941,
2 however, by 1971, Haagensen et al. had recognized that “Lobular carcinoma in situ is a misleading and unfortunate name for this benign, noninfiltrating, special microscopical form of lobular proliferation of the mammary epithelium”.
3 For a long time, it was popular to teach that LCIS is a marker of risk for cancer in either breast, and not a precursor of invasive carcinoma. This is partially true. The fact is, women diagnosed with LCIS disproportionately develop invasive lobular carcinoma in the originally affected breast. The frequent occurrence of LCIS in association with invasive lobular carcinoma suggests it may be a precursor lesion. Indeed, it was recently demonstrated that LCIS is clonally related to associated ductal carcinoma in situ (DCIS) and invasive lobular carcinoma in 42% of synchronous cases.
4 LCIS is a non-obligate precursor of invasive lobular carcinoma and a marker of a breast microenvironment that is permissive for the outgrowth of invasive breast cancers. Invasive cancer risk is much lower for LCIS than for untreated DCIS. The subsequent cancers are frequently multifocal/multicentric, and may develop in other quadrants or even in the opposite breast. For these reasons, LCIS is not treated surgically. …
