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Clinical Outcomes of Lobular Carcinoma In Situ: Risk of Invasive Cancer Development.

Doyoun Woen1, Ki Jo Kim1, Su Min Lee1

  • 1Division of Breast Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

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Summary

Tamoxifen did not significantly reduce invasive cancer risk in pure lobular carcinoma in situ (LCIS) patients. Pleomorphic LCIS, a subtype of LCIS, may indicate a higher risk for invasive cancer development.

Keywords:
Breast Carcinoma In SituBreast NeoplasmsNeoplasm InvasivenessNeoplasms by Histologic TypeTamoxifen

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Area of Science:

  • Oncology
  • Breast Cancer Research
  • Pathology

Background:

  • Lobular carcinoma in situ (LCIS) is a non-obligate precursor to invasive breast cancer.
  • Current management guidelines, post-AJCC 8th edition, favor surveillance over surgery for pure LCIS.
  • Limited data exists on invasive cancer risk factors in pure LCIS without co-existing DCIS or invasive components.

Purpose of the Study:

  • To investigate the incidence of invasive cancer following a diagnosis of pure LCIS.
  • To evaluate the impact of tamoxifen use on invasive cancer development.
  • To assess the association between LCIS histologic subtypes and invasive cancer risk.

Main Methods:

  • Retrospective analysis of 106 patients diagnosed with pure LCIS between 2008 and 2018.
  • Evaluation of tamoxifen use and LCIS histologic type (classic vs. pleomorphic).
  • Surgical management for all patients, followed by median 67.5-month follow-up.

Main Results:

  • Nine patients (8.5%) developed invasive cancer.
  • Invasive cancer incidence was lower in the tamoxifen group (6.3%) versus non-tamoxifen (11.9%), but not statistically significant (p=0.266).
  • Pleomorphic LCIS showed a significantly higher incidence (30.0%) of invasive cancer compared to classic LCIS (6.3%) (p=0.045).

Conclusions:

  • Postoperative tamoxifen did not significantly reduce invasive cancer incidence in pure LCIS.
  • Pleomorphic LCIS is associated with a higher risk of subsequent invasive cancer compared to classic LCIS.
  • Histologic subtype of LCIS should guide personalized surveillance and treatment strategies.