How is stage 0 (lobular carcinoma in situ) breast cancer treated?

Updated: Apr 23, 2020
  • Author: Joseph A Sparano, MD; Chief Editor: John V Kiluk, MD, FACS  more...
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Answer

Answer

Management options include the following:

  • Surveillance alone (ie, mammography)

  • Surveillance plus raloxifene (for postmenopausal women)

  • Tamoxifen (for women of any menopausal status) [3, 4]

  • Bilateral prophylactic mastectomy (usually in patients who are very concerned about breast cancer risk and have either a strong family history or mammographically dense breasts that impair surveillance)

If LCIS is detected on stereotactic biopsy, wide excision is indicated. In 10-20% of cases, this may reveal invasive cancer or ductal carcinoma in situ (DCIS) that requires additional local or systemic therapy [5]

Surgical excision to negative margins is not indicated; however, LCIS is associated with about a 5% 5-y risk and a 20-30% lifetime risk of developing invasive breast cancer, which may be ipsilateral or contralateral and may be ductal or lobular in origin [6] Pleomorphic LCIS is a LCIS variant that warrants special consideration in that treatment should include excision to negative margins. [7]


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