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Presence of Non-classic LCIS Is Not a Contraindication to Breast Conservation in Patients with Concomitant Invasive Breast Cancer or DCIS

  • Breast Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Non-classic lobular carcinoma in situ (NC-LCIS) represents a spectrum of lesions, histologically distinct from classic LCIS (C-LCIS) and ductal carcinoma in situ (DCIS). Several studies have reported on the safety of breast conservation (BCS) in patients with DCIS or invasive breast cancer and concomitant C-LCIS, yet there are no data addressing this question for patients with concomitant NC-LCIS. We evaluated local recurrence (LR) after BCS in patients with DCIS or invasive cancer and concomitant NC-LCIS.

Patients and Methods

We searched institutional databases using natural language processing to identify patients with DCIS or invasive breast cancer and concomitant NC-LCIS treated with BCS between 2000 and 2015. Charts were reviewed to collect demographics, disease and treatment details, and recurrence events. All results represent descriptive analyses.

Results

We identified 71 patients with DCIS (n = 13) or invasive cancer (n = 58) and concomitant NC-LCIS treated with BCS. Median patient age was 59 years (33–77 years), and median invasive tumor size was 1.2 cm (0.1–6.9 cm); 62% of DCIS and 79% of invasive cancer patients had hormone receptor (HR)-positive disease. Among DCIS patients, seven (54%) received radiation and none hormonal therapy. Among those with invasive cancer, 52 (90%) received radiation, 17 (29%) received chemotherapy and 44 of 55 with HR-positive disease (78%) received hormonal therapy. At median follow-up of 79 months (1–265 months), the LR rate was 8% and 2% among patients with DCIS and invasive cancer, respectively.

Conclusion

NC-LCIS is rarely present in association with DCIS or invasive cancer, and it does not appear to impact LR outcomes following BCS.

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Data Availability

The data are available in a REDCap database created for this study upon receiving IRB approval. Please contact the corresponding author to get access to the database.

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Authors and Affiliations

  1. Division of Breast Surgery, Department of Surgery, Brigham and Women’s Hospital, Boston, MA, USA

    Faina Nakhlis MD, Fisher D. Katlin BS, Samantha C. Grossmith MS, Ashley DiPasquale MD, MSc & Tari A. King MD

  2. Breast Oncology Program, Dana-Farber Brigham Cancer Center, Boston, MA, USA

    Faina Nakhlis MD, Fisher D. Katlin BS, Samantha C. Grossmith MS, Ashley DiPasquale MD, MSc & Tari A. King MD

  3. Harvard T.H. Chan School of Public Health, Boston, MA, USA

    Ashley DiPasquale MD, MSc

  4. Department of Pathology, Brigham and Women’s Hospital, Boston, MA, USA

    Beth T. Harrison MD & Stuart J. Schnitt MD

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  1. Faina Nakhlis MD
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Contributions

All authors contributed equally to the study design, data analysis, and manuscript preparation.

Corresponding author

Correspondence to Faina Nakhlis MD.

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Disclosure

T.A.K. reports speakers honoraria and an advisory board role for Exact Sciences (formerly Genomic Health), and is on the global advisory board of Besins Healthcare. The remaining authors have no conflicts to declare.

Ethics Approval

This research was approved by the Dana-Farber/Harvard Cancer Center Institutional Review Board (study number 16-161).

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Nakhlis, F., Katlin, F.D., Grossmith, S.C. et al. Presence of Non-classic LCIS Is Not a Contraindication to Breast Conservation in Patients with Concomitant Invasive Breast Cancer or DCIS. Ann Surg Oncol 29, 7696–7702 (2022). https://doi.org/10.1245/s10434-022-12066-2

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