After a biopsy of your breast for another reason, did your doctor tell you that you have a condition called LCIS? You must have been very scared when you heard the word 'carcinoma'. Because when we hear that word, we immediately think of cancer. But don't worry. We will talk in a simple way that you can understand what LCIS really is, is it cancer, and what to do about it.
What exactly is LCIS?
Simply put, LCIS is the growth of abnormal cells in the milk-producing glands (lobules) of your breasts. Think about it, the cells in our bodies are constantly dividing and renewing themselves. So when the cells inside these milk glands divide, they start to grow into slightly different, abnormal cells instead of normal cells. That's what LCIS is.
The most important thing you need to remember here is that, despite the word 'carcinoma' in the name, LCIS is not breast cancer. Although it is considered by some to be a precursor to cancer, it is not cancer itself.
These abnormal cells are in a state called 'in situ'. That means they stay where they are and haven't spread to other parts of the breast. That's why it's not dangerous.
But, having LCIS means that you have a slightly higher risk of developing breast cancer in the future than the average person. It's like a warning sign on the road. It tells you that there may be a danger ahead, so drive carefully. LCIS is that kind of warning.
What are the main types of LCIS?
Doctors look at the abnormal cells under a microscope and divide LCIS into three main types based on how they look. Knowing which type you have is very important for deciding on treatment.
| LCIS type | How it looks under a microscope (simplified) |
|---|---|
| Classic LCIS | The abnormal cells lining the mammary glands appear smaller than normal cells. This is the most common type. |
| Pleomorphic LCIS | Here, the abnormal cells are larger than normal cells and their appearance is very different. |
| Florid LCIS (Florid LCIS) | Abnormal cells have gathered together to form a mass. Sometimes, a mass of dead cells can be seen in the middle of the mass. |
Are there any symptoms of LCIS?
Most of the time, LCIS does not have any specific symptoms. That means you don't feel like you have a lump in your breast, you don't feel pain, and you don't have any discharge from the breast.
So how is it diagnosed? Most of the time, it's discovered incidentally. For example, LCIS is diagnosed during a biopsy done for another reason, perhaps because of a change seen on a mammogram or because of another lump felt in the breast.
What are the possible complications of LCIS?
This is the thing that scares many people. Not everyone with LCIS will develop cancer. Keep that in mind. However, studies have shown that about one in ten (10%) people with LCIS have a chance of developing breast cancer in the future, especially a condition called `ductal carcinoma in situ (DCIS)` or `lobular breast cancer`.
It's important to talk to your doctor about this risk and ask them clearly what your risk is, as this risk can vary depending on factors such as the type of LCIS you have and your family history of cancer.
What is the treatment for LCIS?
The treatment you receive depends entirely on the type of LCIS you have. Not everyone is treated the same way.
1. Active Surveillance
If you have 'Classic LCIS', your doctor will often recommend this approach. This involves keeping a close eye on your condition without giving you any medication or surgery.
- Have a breast exam by your doctor every 6 months .
- Having a mammogram every year .
- Additional tests, such as a breast MRI scan, may also be recommended.
2. Preventive Therapy
The goal of these treatments is to prevent those abnormal cells from becoming cancerous. They use drugs that help reduce the risk of cancer.
- For this, you can use drugs such as `Selective Estrogen Receptor Modulators (SERM)` or `Aromatase Inhibitors`. These help reduce the risk of estrogen-sensitive (ER-positive) cancers in particular. Your doctor will explain this to you in more detail.
3. Surgery
Surgery is often recommended for people with 'Pleomorphic' or 'Florid' types of LCIS, as those types have a slightly higher risk of developing cancer.
- Lumpectomy: This involves surgically removing only the area with the abnormal cells and a small amount of healthy tissue around it.
- Prophylactic Bilateral Mastectomy: This is a slightly larger operation. In this, both breasts are removed. However, it is recommended in very high-risk cases. For example, if a close family member, such as your mother, sister, or daughter, has had breast cancer, your doctor may discuss this option with you.
What can we do to reduce the risk of LCIS?
Although there is no specific way to prevent LCIS, there are several things you can do to reduce your risk of developing breast cancer.
- Control your weight: Obesity is a major risk factor for breast cancer. So try to maintain a healthy weight.
- Regular exercise: It is best to do at least 150 minutes a week (e.g. 30 minutes a day, 5 days a week) of moderate-intensity exercise such as walking or cycling.
- Limit alcohol consumption: Research has shown a link between alcohol and breast cancer. Therefore, it is important to completely stop or severely limit alcohol consumption.
- Be aware of medications you are taking: If you are taking hormone therapy or certain types of birth control pills, be sure to talk to your doctor about the risk of these with LCIS. They may recommend switching to a different medication.
How do I take care of myself while living with LCIS?
When you find out you have LCIS, you feel scared, but you also need to take extra care of your body.
- Breast self-examination: Check your breasts every month. If you notice anything new, such as a lump, skin change, or lump, see your doctor right away.
- Be aware of the changes: Ask your doctor about the possible symptoms if LCIS turns into cancer.
- Don't miss your appointments: Be sure to attend all follow-up appointments that your doctor gives you. These tests will help you quickly identify any changes.
It's normal to feel scared when you receive a diagnosis of LCIS. But it doesn't mean you have cancer. It just means you need to take a little more care of your health. With the right information and a collaborative approach with your doctor, you can live a healthy, happy life with this condition.
Take-Home Message
- LCIS (Lobular Carcinoma in Situ) is not breast cancer, but it is a condition that increases the risk of developing breast cancer in the future.
- This condition usually has no symptoms and is often diagnosed during a biopsy performed for another reason.
- Treatment depends on the type of LCIS you have. For some people, observation alone is enough, while others may need medication or surgery.
- Talk openly with your doctor and understand your risks and treatment options. Don't be afraid and make informed decisions.
- A healthy lifestyle (maintaining a healthy weight, exercising, limiting alcohol) helps reduce the risk of breast cancer.
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