Poster Presentation Joint 2016 COSA and ANZBCTG Annual Scientific Meeting

Clinical guidance for management of lobular carcinoma in situ (#281)

Briony Jack 1 , Vivienne Milch 1 , Sarah Norris 1 , Sunil Lakhani 2 , Helen Zorbas 1
  1. Cancer Australia, Strawberry Hills, NSW, Australia
  2. University of Queensland, St Lucia, QLD, Australia

Aims

Lobular carcinoma in situ (LCIS) is a non-invasive neoplastic proliferation of epithelial cells within the lobules and terminal ducts of the breast. LCIS is usually detected as an incidental finding in core needle or excision biopsies of benign or malignant breast tissue. This guidance aims to provide health professionals within a multidisciplinary team with information to assist in the management of women with LCIS.

Methods

Cancer Australia convened a multidisciplinary working group (WG) which included representatives from professional colleges and groups including MOGA. A systematic review was undertaken to identify evidence on the management of LCIS to inform the development of the guidance document.

Results

The evidence identified in the systematic review was insufficient to develop a clinical practice guideline. Consequently, consensus guidance was developed by the WG, with external review by peak organisations including MOGA. The guidance includes consensus practice points including:

  • The diagnosis and management of women with LCIS should involve a multidisciplinary team who consider all relevant pathological, radiological and clinical data, and the individual patient’s risk profile and preferences.
  • Patient involvement in the choice of management options is a key aspect of care. Women should receive adequate information regarding the implications of a diagnosis of LCIS, and the risks and benefits of the different management options.
  • Management options for the majority of women with LCIS include surveillance, surgical excision, and risk-reducing medication.

Practice points for the management of the newly described rare LCIS subtypes, which include pleomorphic LCIS, classic LCIS with comedo-type necrosis and florid/bulky LCIS, have also been developed.

Conclusions

In the context of limited evidence, women with LCIS should be managed by a multidisciplinary team and should receive an explanation of the implications of the diagnosis, management and surveillance options according to the subtype of LCIS identified.