Lobular Breast Carcinoma in Situ(LCIS)

Diagnosis

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Lobular Breast Carcinoma in situ (LCIS) is very difficult to detect in its early stages because it does not produce any specific symptoms. The only specific way of diagnosing LCIS is by a biopsy.

It does not show up in a routine screening mammography or in an ultrasound.

Most experts do not consider it a carcinoma at all but a neoplasia. A neoplasia is a collection of abnormal cells.

In most cases, a thickened area may be seen on mammography or an ultrasound done due to some other cause. Biopsy of the thickened area will reveal LCIS.

DIagnostic Tests for Lobular Breast Carcinoma in Situ (LCIS)

Breast Biopsy: The only definitive way to diagnose LCIS is by a breast biopsy. Clinically, it is difficult to diagnose LCIS. Like all other types of breast cancers, a lump or a suspicious area seen on a mammogram will need to undergo a breast biopsy for an accurate diagnosis. There are different types of breast biopsies.

  • Fine Needle Aspiration Biopsy: This procedure uses a very thin needle and syringe to remove either fluid from a cyst or clusters of cells from a solid mass. Removal of tissue from a small mass with a fine needle requires a great deal of expertise and is generally done under ultrasound guidance.

  • Core Needle Biopsy: This procedure uses a somewhat larger needle with a sharp cutting edge. A core of tissue is cut from inside the mass. If the breast mass is quite large, as many as 15 samples, each about the size of a grain of rice, may be taken and sent to a lab for microscopic analysis.

    Lobular Breast Carcinoma in Situ Diagnosis

  • Stereotactic Biopsy: This is a procedure in which tissue is removed from lumps which can be seen on a mammogram but cannot be felt on physical examination. It is done under the guidance of a mammogram or ultrasound. It helps in accurate localizing of the suspicious area.

  • Surgical Biopsy: In surgical biopsy, the suspicious area is first identified by mammogram. A needle is then inserted and fixed in the mass. Using this needle as a guide, the lump can be more accurately identified on the operating table and biopsied. If the lump is quite small, it may be completely removed - it is then called an excision biopsy.
Mammography, Ultrasound : These tests cannot identify LCIS. While DCIS (Ductal Carcinoma in Situ) can be suspected during these investigative procedures due to the presence of microcalcifications, LCIS does not cause any microcalcifications and can be missed in mammography or ultrasound.

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