Current treatment for lobular carcinoma in situ.

Abstract

We thought that observation for patients with lobular carcinoma in situ (LCIS) had been generally accepted by the mid-1980s. A questionnaire mailed to oncologic surgeons in 1988 revealed that 33% of the respondents still advised unilateral mastectomy, although a slim majority (54%) advised observation. New studies have been published in the intervening 8 years, and we decided it would be worth recirculating the 1988 questionnaire. The identical questionnaire was mailed to members of the same oncologic societies (Society of Surgical Oncology [SSO] and Society for the Study of Breast Disease), but changes in membership necessitated new mailing lists. Observation has yet to be universally accepted by the oncologic community, but at this time 85% of the respondents suggest it as the preferred option for their patients. Recent studies have questioned some of the tenets laid down by Haagensen in 1978, but it appears clear that his formulation of LCIS as a marker of increased risk continues to gain ground over the original concept of inevitable progression to invasive disease.