Lobular carcinoma in situ: A 29-year longitudinal experience evaluating clinicopathologic features and breast cancer risk Journal Article

Authors: King, T. A.; Pilewskie, M.; Muhsen, S.; Patil, S.; Mautner, S. K.; Park, A.; Oskar, S.; Guerini Rocco, E.; Boafo, C.; Gooch, J. C.; De Brot, M.; Reis-Filho, J. S.; Morrogh, M.; Andrade, V. P.; Sakr, R. A.; Morrow, M.
Article Title: Lobular carcinoma in situ: A 29-year longitudinal experience evaluating clinicopathologic features and breast cancer risk
Abstract: Purpose The increased breast cancer risk conferred by a diagnosis of lobular carcinoma in situ (LCIS) is poorly understood. Here, we review our 29-year longitudinal experience with LCIS to evaluate factors associated with breast cancer risk. Patients and Methods Patients participating in surveillance after an LCIS diagnosis are observed in a prospectively maintained database. Comparisons were made among women choosing surveillance, with or without chemoprevention, and those undergoing bilateral prophylactic mastectomies between 1980 and 2009. Results One thousand sixty patients with LCIS without concurrent breast cancer were identified Median age at LCIS diagnosis was 50 years (range, 27 to 83 years). Fifty-six patients (5%) underwent bilateral prophylactic mastectomy; 1,004 chose surveillance with (n = 173) or without (n = 831) chemoprevention. At a median follow-up of 81 months (range, 6 to 368 months), 150 patients developed 168 breast cancers (63% ipsilateral, 25% contralateral, 12% bilateral), with no dominant histology (ductal carcinoma in situ, 35%; infiltrating ducta carcinoma, 29%; infiltrating lobular carcinoma, 27%; other, 9%). Breast cancer incidence was significantly reduced in women taking chemoprevention (10-year cumulative risk: 7% with chemoprevention; 21% with no chemoprevention; P <.001). In multivariable analysis, chemoprevention was the only clinical factor associated with breast cancer risk (hazard ratio, 0.27; 95% CI, 0.15 to 0.50). In a subgroup nested case-control analysis, volume of disease, which was defined as the ratio of slides with LCIS to total number of slides reviewed, was also associated with breast cancer development (P =.008) Conclusion We observed a 2% annual incidence of breast cancer among women with LCIS. Common clinical factors used for risk prediction, including age and family history, were not associated with breast cancer risk. The lower breast cancer incidence in women opting for chemoprevention highlights the potential for risk reduction in this population. © 2015 American Society of Clinical Oncology. All rights reserved.
Keywords: adult; controlled study; human tissue; aged; cancer surgery; major clinical study; clinical feature; histopathology; cancer risk; cancer patient; follow up; cancer incidence; disease association; chemoprophylaxis; mastectomy; breast carcinoma; intraductal carcinoma; longitudinal study; lobular carcinoma in situ; bibliographic database; disease surveillance; human; female; priority journal; article
Journal Title: Journal of Clinical Oncology
Volume: 33
Issue: 33
ISSN: 0732-183X
Publisher: American Society of Clinical Oncology  
Date Published: 2015-11-20
Start Page: 3945
End Page: 3952
Language: English
DOI: 10.1200/JCO.2015.61.4743
PROVIDER: scopus
PUBMED: 26371145
PMCID: PMC4934644
Notes: Article -- Export Date: 7 January 2016 -- 3945 -- Source: Scopus
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MSK Authors
  1. Sujata Patil
    386 Patil
  2. Monica Morrow
    450 Morrow
  3. Tari King
    167 King
  4. Mary Morrogh
    33 Morrogh
  5. Rita Sakr
    59 Sakr
  6. Shirin Muhsen
    26 Muhsen
  7. Victor Piana De Andrade
    25 Andrade
  8. Starr Britni Koslow
    14 Koslow
  9. Anna Yong Park
    22 Park
  10. Jorge Sergio Reis
    285 Reis
  11. Jessica Charlotte Gooch
    6 Gooch
  12. Sabine   Oskar
    7 Oskar