{"entity":{"id":"lobular-carcinoma-in-situ","kind":"cancer","name":"Lobular carcinoma in situ (LCIS)","aka":["LCIS","Lobular neoplasia","Classic lobular carcinoma in situ","Pleomorphic lobular carcinoma in situ","Florid lobular carcinoma in situ","Atypical lobular hyperplasia (lesser form)"],"tldr":"Lobular carcinoma in situ is not an invasive breast cancer but a marker that a woman is at higher risk of one: abnormal cells fill the milk-producing lobules without spreading. About one in five women develop breast cancer within ten years, in either breast and of any type; preventive tamoxifen cuts that to about one in fourteen, and the pleomorphic form is excised like ductal carcinoma in situ.","summary":"The WHO classification lists lobular carcinoma in situ among the lobular neoplasias, with atypical lobular hyperplasia as its lesser form and the pleomorphic and florid variants as higher-risk forms; like invasive lobular carcinoma it has lost E-cadherin (Tan 2020). In the Memorial Sloan Kettering cohort of 1,060 women with LCIS alone, 5 percent chose bilateral prophylactic mastectomy and 1,004 chose surveillance, 173 of them with chemoprevention; at a median follow-up of 81 months, 150 women developed 168 breast cancers (63 percent in the same breast, 25 percent in the other, 12 percent both), with no dominant histology (ductal carcinoma in situ 35 percent, invasive ductal 29 percent, invasive lobular 27 percent), and the ten-year cumulative risk was 7 percent with chemoprevention against 21 percent without (King 2015). Pleomorphic LCIS behaves differently: of 21 patients with pure pleomorphic LCIS on biopsy who had excision, 33.3 percent were found to have invasive carcinoma and 19 percent ductal carcinoma in situ, and the lesion was extensive or multifocal in 47.6 percent (Annals of Surgical Oncology 2015).\n\nHow it differs from its parent: it is a risk lesion and precursor rather than a cancer, is not staged, and its management is surveillance and prevention rather than treatment of a tumour, which is why it sits beside ductal carcinoma in situ under the breast cancer page.\n\nHow common: no incidence figure is given in the sources read.\n\nTreatment: for classic LCIS found on core biopsy, surveillance with annual imaging and consideration of chemoprevention with tamoxifen or an aromatase inhibitor (the low-dose tamoxifen trial TAM-01 included lobular carcinoma in situ among its intraepithelial neoplasias); excision to clear margins for pleomorphic or florid LCIS, given the upgrade rate; bilateral mastectomy only by informed choice (King 2015).","asOf":"2026-09-24","wikipedia":"https://en.wikipedia.org/wiki/Lobular_carcinoma_in_situ","links":[{"label":"Tan 2020, Histopathology: the 2019 WHO classification of tumours of the breast","url":"https://doi.org/10.1111/his.14091"},{"label":"King 2015, JCO: lobular carcinoma in situ, a 29-year longitudinal experience of 1,060 patients","url":"https://doi.org/10.1200/jco.2015.61.4743"},{"label":"Annals of Surgical Oncology 2015: pleomorphic lobular carcinoma in situ, features and management","url":"https://doi.org/10.1245/s10434-015-4552-x"},{"label":"Cancer Research UK: types of breast cancer","url":"https://www.cancerresearchuk.org/about-cancer/breast-cancer/types"}],"tags":["subtype-page","wave4","breast"],"related":["breast-cancer","ductal-carcinoma-in-situ","invasive-lobular-carcinoma","breast-hr-positive"],"cancers":[],"sections":[],"technologies":[],"targets":["cdh1"],"drugs":["tamoxifen"],"companies":[],"institutions":[],"pathways":[],"terms":["aromatase-inhibitor","carcinoma-in-situ","mastectomy"],"trials":["tam-01"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"group":"breast","burden":"Found in a minority of breast biopsies, usually by chance; Memorial Sloan Kettering followed 1,060 women with LCIS and no concurrent cancer over 29 years, median age at diagnosis 50 (King 2015). No population incidence is given in the sources read.","subtypes":["Classic lobular carcinoma in situ (surveillance and chemoprevention)","Pleomorphic lobular carcinoma in situ (excised like ductal carcinoma in situ)","Florid lobular carcinoma in situ","Atypical lobular hyperplasia (lesser lobular neoplasia)"],"biomarkers":["E-cadherin loss","Oestrogen receptor (positive in classic LCIS)","Pleomorphic or florid morphology (upgrade risk)","Extent on MRI when considering excision"],"standardOfCare":[{"setting":"Classic LCIS on biopsy","approach":"Surveillance and chemoprevention (tamoxifen or an aromatase inhibitor); TAM-01 tested low-dose tamoxifen in intraepithelial neoplasia.","refs":["tamoxifen","tam-01","aromatase-inhibitor"]},{"setting":"Pleomorphic or florid LCIS","approach":"Excision to clear margins because of the upgrade rate to invasive cancer or ductal carcinoma in situ.","refs":["ductal-carcinoma-in-situ","mastectomy"]}],"stateOfArt":[],"history":[],"pipeline":[],"openProblems":[],"parent":"breast-cancer"},"route":"/cancers/lobular-carcinoma-in-situ/","neighbours":{"cancer":[{"id":"breast-cancer","kind":"cancer","name":"Breast cancer (all types)","route":"/cancers/breast-cancer/"},{"id":"ductal-carcinoma-in-situ","kind":"cancer","name":"Ductal carcinoma in situ (DCIS)","route":"/cancers/ductal-carcinoma-in-situ/"},{"id":"breast-hr-positive","kind":"cancer","name":"HR-positive / HER2-negative breast cancer","route":"/cancers/breast-hr-positive/"},{"id":"invasive-lobular-carcinoma","kind":"cancer","name":"Invasive lobular carcinoma of the breast","route":"/cancers/invasive-lobular-carcinoma/"}],"target":[{"id":"cdh1","kind":"target","name":"CDH1","route":"/targets/cdh1/"}],"drug":[{"id":"tamoxifen","kind":"drug","name":"Tamoxifen","route":"/drugs/tamoxifen/"}],"term":[{"id":"aromatase-inhibitor","kind":"term","name":"Aromatase inhibitor","route":"/terms/aromatase-inhibitor/"},{"id":"carcinoma-in-situ","kind":"term","name":"Carcinoma in situ (CIS)","route":"/terms/carcinoma-in-situ/"},{"id":"mastectomy","kind":"term","name":"Mastectomy","route":"/terms/mastectomy/"}],"trial":[{"id":"tam-01","kind":"trial","name":"TAM-01","route":"/trials/tam-01/"}]}}