LCIS is not cancer, so active treatment may not be necessary. It’s not life threatening, so you can take your time making treatment decisions. A few factors that can influence these decisions are:
the cells are very abnormal (pleomorphic)there are areas of dead cells (necrosis)you have a personal or family history of breast cancerpersonal preference
Your doctor may recommend removing the abnormal tissue. Surgical options include breast excisional biopsy or breast conserving surgery (lumpectomy) to remove the abnormal area plus a margin of healthy tissue.
Another option is prophylactic mastectomy, which is surgical removal of the breast to lower the risk of breast cancer. It’s not usually recommended for LCIS. Some women who have additional risk factors, such as BRCA gene mutations might be more inclined to choose this surgery.
LCIS increases breast cancer risk in both breasts, so both would be removed. Because there’s no cancer, there’s no need to remove lymph nodes under the armpits (axillary lymph nodes). Removal of the entire breast, including the skin, nipple, and areola, is called simple mastectomy.
You can also choose to have nipple-sparing or skin-sparing mastectomy. If you want to, you can start breast reconstruction surgery immediately following any of these procedures.
Cancer treatments such as chemotherapy and radiation therapy are not needed. If you’re at high risk for breast cancer due to other reasons, your doctor might recommend preventive medicine (chemoprevention) such as tamoxifen or raloxifene.
Be sure to discuss the potential benefits and risks of all options with your doctor.
LCIS means you’re at higher risk for breast cancer, so it’s important to discuss follow-up screening with your doctor. This may include scheduling regular screenings:
doctor’s visits with clinical breast examsbreast self-examsmammography
Speak with your doctor if you have new symptoms or notice any changes to your breasts. Warning signs of breast cancer include:
a lumpchange in size or shape of breastinverted nipple, nipple dischargerash, thickening, or dimpling of the skin on the breastswelling under the armpit
In addition to LCIS there are many factors that affect breast cancer risk. If you have a family history of breast or other cancers, ask your doctor if genetic testing is advisable. You might also want to discuss other ways to lower your risk, which may include:
regular exercisehealthy dietlimited alcoholmaintaining a moderate weightavoid taking estrogen (hormones)