Lobular Carcinoma in Situ - Early Signs, Risk Factors, Diagnosis, and Treatment Explained

Lobular carcinoma in situ (LCIS) is a condition where abnormal cells grow in the lobules of the breast. Lobules are the glands that produce breast milk. Unlike invasive breast cancer, lobular carcinoma in situ does not spread beyond the lobules into nearby breast tissue. This means lobular carcinoma in situ itself is not considered cancer but rather a marker that a woman has a higher risk of developing breast cancer in the future.

Lobular carcinoma in situ is relatively uncommon compared to other breast conditions. It is usually found during a biopsy done for another reason, since it rarely causes symptoms or shows up on a mammogram. Detecting lobular carcinoma in situ early is important because it allows doctors to closely monitor a woman's breast health and take preventive steps if needed.

What Are the Types of Lobular Carcinoma in Situ?

There are a few subtypes of lobular carcinoma in situ, and understanding them can help patients know what their diagnosis means:

• Classic LCIS: This is the most common type. Abnormal cells remain inside the lobules and do not spread. It is usually found incidentally on a biopsy.
• Pleomorphic LCIS: It is less common but more concerning. The abnormal cells look more aggressive under the microscope. They may behave more like ductal carcinoma in situ (DCIS) and require closer follow-up or treatment.
• Florid LCIS: This is a variant where lobules are more extensively filled with abnormal cells. It is often treated more actively than classic LCIS.

What Are the Causes of Lobular Carcinoma in Situ?

Doctors do not know the exact cause of lobular carcinoma in situ. Like most breast conditions, it likely develops due to a mix of genetic changes, hormonal influences, and environmental factors. Lobular carcinoma in situ is not caused by something a patient did or did not do. Instead, it reflects changes in how breast cells grow and divide.

What Are the Risk Factors for Lobular Carcinoma in Situ?

Certain factors can increase the chance of developing lobular carcinoma in situ:

• Age: Most cases occur in women over age 55
• Gender: Women are at much higher risk, but men can also develop ILC
• Family history of breast cancer: Having close relatives with breast or ovarian cancer increases risk
• Inherited genetic mutations: BRCA1 and BRCA2 mutations are linked to lobular cancer
• Hormone replacement therapy (HRT): Long-term use of estrogen and progesterone after menopause raises risk
• Reproductive history: Early menstruation, late menopause, or never having children may increase risk
• Lifestyle factors: Obesity, alcohol use, and lack of physical activity can contribute
• Previous radiation therapy to the chest: Raises risk years later

Having one or more risk factors does not mean someone will definitely get lobular carcinoma in situ, but it does increase the likelihood.

What Are the Symptoms of Lobular Carcinoma in Situ?

One of the most challenging aspects of lobular carcinoma in situ is that it usually does not cause any symptoms. Women typically do not feel a lump, pain, or nipple changes. It is often discovered by chance during a biopsy for another breast issue. Rarely, lobular carcinoma in situ may be found in women who undergo surgery for a different breast concern. Because it is usually silent, regular screening is essential for early detection of other breast changes.

How Is Lobular Carcinoma in Situ Diagnosed?

Since lobular carcinoma in situ does not form a lump and is usually invisible on mammograms, it is most often diagnosed through a biopsy.

The diagnosis process may include:

• Mammogram or ultrasound: While lobular carcinoma in situ itself may not appear, these tests may show another abnormality that leads to a biopsy.
• Core needle biopsy: A small tissue sample is taken and examined under a microscope.
• Excisional biopsy: If needed, doctors may remove more tissue to confirm the diagnosis.
• A pathologist then reviews the sample to determine if it is classic, pleomorphic, or florid lobular carcinoma in situ.

Staging of Lobular Carcinoma in Situ

Unlike invasive breast cancers, lobular carcinoma in situ is not staged because it has not spread beyond the lobules. Instead, doctors classify it based on its appearance under the microscope:

• Classic LCIS: Lower concern, usually managed with monitoring.
• Pleomorphic/Florid LCIS: Higher concern, may require treatment similar to ductal carcinoma in situ.

What Are the Treatment Options for Lobular Carcinoma in Situ?

Lobular carcinoma in situ itself does not usually need aggressive treatment.

Options may include:

Surgery

• Rarely, surgery may be advised if pleomorphic or florid lobular carcinoma in situ is found.
• In very high-risk women (such as BRCA mutation carriers), preventive mastectomy may be considered.

Medical Treatment

• Hormone-blocking drugs like tamoxifen, raloxifene, or aromatase inhibitors can lower breast cancer risk.

Radiation Therapy

• Radiation is not standard for lobular carcinoma in situ. It may be considered if the condition behaves like ductal carcinoma in situ.

What is the Prognosis for Lobular Carcinoma in Situ?

The outlook for lobular carcinoma in situ is very good. Lobular carcinoma in situ itself does not shorten life expectancy because it is not invasive cancer. However, women with lobular carcinoma in situ are about 7--12 times more likely to develop invasive breast cancer in the future compared to women without lobular carcinoma in situ. With regular monitoring and preventive strategies, most women live long, healthy lives. The key is staying proactive with follow-up care.

Screening and Prevention of Lobular Carcinoma in Situ

Women with lobular carcinoma in situ should follow a personalized screening plan. This may include:

• Imaging: Annual mammograms starting earlier than average. Breast MRI for high-risk women.
• Breast exam: Clinical breast exams by a doctor every 6--12 months.
• Lifestyle Changes: Maintaining a healthy weight, regular exercise, avoiding alcohol and smoking, and avoiding unnecessary hormone therapy.

For International Patients

People from around the world come to Apollo Hospitals for the treatment of lobular carcinoma in situ. Our international patient services team will guide you all the way from seeking the first virtual connect all the way to treatment in India and then returning home post treatment.

Services include:

• Medical opinions and scheduling
  • Pre-arrival medical review of reports and imaging.
• Travel and logistics
  • Assistance with visa invitation letters, airport transfers, and nearby accommodation options.
  • Dedicated international patient coordinators to guide through each step.
• Language and cultural support
  • Interpreter services in multiple languages.
  • Clear, simple explanations at every stage with written care plans.
• Financial coordination
  • Transparent treatment estimates and packages when possible.
  • Support with international payment methods and insurance coordination.
• Continuity of care
  • Shared records, imaging, and treatment summaries for home doctors.
  • Telemedicine follow-ups for convenience after returning home.

Frequently Asked Questions (FAQs)

1. Is lobular carcinoma in situ an invasive type of breast cancer?

No, lobular carcinoma in situ is not invasive cancer. It is a marker that increases the risk of future breast cancer.

2. What is the survival rate for lobular carcinoma in situ?

The survival rate is excellent. Lobular carcinoma in situ does not cause death, but monitoring is needed since the risk of developing breast cancer is higher.

3. Can lobular carcinoma in situ come back after treatment?

Yes, LCIS may be found again in another part of the breast, or invasive cancer may develop later. This is why regular follow-up is critical.

4. What are the side effects of lobular carcinoma in situ treatment?

Since most women are managed with observation, there are no direct side effects. If hormone-blocking medicines are used, side effects may include hot flashes, joint pain, or bone thinning.

5. How long is the recovery time after lobular carcinoma in situ surgery?

If surgery is needed, recovery is usually short; most women resume normal activities within 1--2 weeks.

6. Can lobular carcinoma in situ be cured?

There is no "cure" needed, since lobular carcinoma in situ is not invasive cancer. Instead, it is managed with close monitoring and prevention.