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Symptoms and Diagnosis of LCIS

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Lobular Carcinoma in Situ
Lobular Carcinoma in SituLarger Version

It is difficult to detect LCIS on your own. Doctors usually find LCIS through an abnormal mammogram and a biopsy.

Symptoms of LCIS

LCIS usually does not cause any signs or symptoms, such as a lump or other visible changes to the breast. LCIS may not always show up on a screening mammogram. One reason is that LCIS often lacks microcalcifications, the tiny specks of calcium that form within other types of breast cancer cells. On a mammogram, microcalcifications show up as white specks. It’s believed that many cases of LCIS simply go undiagnosed, and they may never cause any problems.

Diagnosing LCIS

LCIS is usually diagnosed after a biopsy is done on the breast for some other reason, such as an abnormal finding on a mammogram or a suspicious breast lump. These biopsy procedures may include the following:

  • Fine needle aspiration biopsy: A very small, hollow needle is inserted into the breast. A sample of cells is removed and examined under the microscope. This method leaves no scars.
  • Core needle biopsy: A larger needle is inserted to remove several bigger samples of tissue from the area that looks suspicious. In order to get the core needle through the skin, the surgeon must make a tiny incision. This leaves a very tiny scar that is barely visible after a few weeks.
  • Incisional biopsy: Incisional biopsy removes a small piece of tissue for examination.
  • Excisional biopsy: Excisional biopsy attempts to remove the entire suspicious lump of tissue from the breast.

To the pathologist looking at the sample under the microscope, LCIS can look very much like ductal carcinoma in situ, or DCIS (cancer that is limited to the breast duct) — especially low-grade, solid DCIS. Unlike LCIS, DCIS is considered to be cancer and does require treatment with surgery and often radiation therapy. So you may want to ask why the pathologist has determined that you have LCIS rather than DCIS. You might also want to seek a second opinion from a pathologist at a different hospital.

In more than half of cases, LCIS is “multifocal,” meaning that multiple lobules have areas of abnormal cell growth inside them. In about one-third of women with LCIS, the other breast is affected as well.

Even though LCIS is not really breast cancer, you may hear your doctor describe it as stage 0. The breast cancer staging system is used to describe how far cancer has spread beyond the site of the original tumor. Both LCIS and DCIS are considered stage 0, the earliest stage possible.

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