- 同
- lobular carcinoma in situ
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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2014/12/19 02:45:26」(JST)
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| Lobular carcinoma in situ |
| Classification and external resources |
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Diagram showing localized and invasive LCIS
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| ICD-10 |
D05.0 |
| ICD-O: |
M8520/2 |
Lobular carcinoma in situ (LCIS) is a condition caused by unusual cells in the lobules of the breast.[1]
Many do not considered it cancer, but it can indicate an increased risk of future cancer.[2][3][4] The national database registrars, however, consider it a malignancy.[5]
Unlike ductal carcinoma in situ (DCIS), LCIS is not associated with calcification, and is typically an incidental finding in a biopsy performed for another reason. LCIS only accounts for about 15% of the in situ (ductal or lobular) breast cancers.[6]
Contents
- 1 Genetics
- 2 Morphology
- 3 Treatment options
- 4 Prognosis
- 5 See also
- 6 References
Genetics
Cells of LCIS and invasive lobular carcinoma have the same histology, appearing as single detached cells, as both have loss of expression of e-cadherin, the transmembrane protein mediating epithelial cell adhesion.[7] LCIS often have the same genetic alterations (such as loss of heterozygosity on chromosome 16q, the locus for the e-cadherin gene) as the adjacent area of invasive carcinoma.[8]
Morphology
Lobular carcinoma in situ, H&E, 20x
Like the cells of atypical lobular hyperplasia and invasive lobular carcinoma, the abnormal cells of LCIS consist of small cells with oval or round nuclei and small nucleoli detached from each other.[9] Mucin-containing signet-ring cells are commonly seen. LCIS generally leaves the underlying architecture intact and recognisable as lobules. Estrogen and progesterone receptors are present and HER2/neu overexpression is absent in most cases of LCIS.[9]
Treatment options
LCIS may be treated with close clinical follow-up and mammographic screening, tamoxifen or related hormone controlling drugs to reduce the risk of developing cancer, or bilateral prophylactic mastectomy. Some surgeons consider bilateral prophylactic mastectomy to be overly aggressive treatment except for certain high-risk cases.[10]
Prognosis
LCIS (lobular neoplasia is considered pre-cancerous) is an indicator (marker) identifying women with an increased risk of developing invasive breast cancer. This risk extends more than 20 years. Most of the risk relates to subsequent invasive ductal carcinoma rather than to invasive lobular carcinoma.[10]
While older studies have shown that the increased risk is equal for both breasts, a more recent study suggests that the ipsilateral (same side) breast may be at greater risk.[11]
See also
- Breast cancer
- Carcinoma in situ
References
- ^ "Lobular Carcinoma in situ (LCIS)". Breast Cancer. Stanford Cancer Center.
- ^ "Lobular carcinoma in situ: Marker for breast cancer risk". MayoClinic.com.
- ^ "Breast Cancer Treatment". National Cancer Institute.
- ^ Afonso N, Bouwman D (August 2008). "Lobular carcinoma in situ". Eur. J. Cancer Prev. 17 (4): 312–6. doi:10.1097/CEJ.0b013e3282f75e5d. PMID 18562954.
- ^ Cancer, American Joint Committee on (2002). AJCC cancer staging handbook : from the AJCC cancer staging manual (6th ed. ed.). New York: Springer. p. 260. ISBN 9780387952703.
- ^ "Susan G. Komen for the Cure | Understanding Breast Cancer | Breast Facts | Statistics | Breast Cancer Statistics". Retrieved 2013-01-16.
- ^ Hajra KM, Fearon ER (2002). "Cadherin and catenin alterations in human cancer". Genes Chromosomes Cancer 34 (3): 255–68. doi:10.1002/gcc.10083. PMID 12007186.
- ^ Lakhani SR (2001). "Molecular genetics of solid tumors: translating research into clinical practice. What we could do now: breast cancer". Mol Pathol 54 (5): 281–4. doi:10.1136/mp.54.5.281. PMC 1187082. PMID 11577167.
- ^ a b Cotran, Ramzi S.; Kumar, Vinay; Fausto, Nelson; Nelso Fausto; Robbins, Stanley L.; Abbas, Abul K. (2005). Robbins and Cotran pathologic basis of disease (7th ed.). St. Louis, MO: Elsevier Saunders. p. 1142. ISBN 0-7216-0187-1.
- ^ a b "Breast Cancer Treatment (PDQ®) - National Cancer Institute - Lobular Carcinoma In Situ". Retrieved 2013-01-12.
- ^ Page DL, Schuyler PA, DuPont WD, Jensen RA, Plummer WD Jr, Simpson JF (2003). "Atypical lobular hyperplasia as a unilateral predictor of breast cancer risk: a retrospective cohort study". Lancet 361 (9352): 125–9. doi:10.1016/S0140-6736(03)12230-1. PMID 12531579.
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Tumors: breast cancer (C50/D24, 174–175/217) – Histopathologic classification
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| Fibroepithelial/stromal |
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| Ductal, lobular, and medullary |
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Ductal
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- Ductal carcinoma in situ (DCIS): Paget's disease of the breast
- Comedocarcinoma
- Invasive ductal carcinoma (IDC)
- Intraductal papilloma
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Lobular
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- Lobular carcinoma in situ (LCIS)
- Invasive lobular carcinoma (ILC)
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Medullary
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Other/ungrouped
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- Inflammatory breast cancer
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| Precursor lesions |
- Atypical ductal hyperplasia
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| Other |
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| Related subjects |
- Main article
- Classification
- Risk factors (Alcohol, Hereditary breast—ovarian cancer syndrome, BRCA mutation)
- Screening
- Treatment
- Breast cancer awareness
- Pink ribbon
- National Breast Cancer Awareness Month
- List of breast cancer patients by occupation
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Glandular and epithelial neoplasms (ICD-O 8010-8589)
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| Epithelium |
Papilloma/carcinoma
(8010-8139) |
- Small cell carcinoma
- Combined small cell carcinoma
- Verrucous carcinoma
- Squamous cell carcinoma
- Basal cell carcinoma
- Transitional cell carcinoma
- Inverted papilloma
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|
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| Glands |
Adenomas/
adenocarcinomas
(8140-8429) |
| Gastrointestinal |
- tract: Linitis plastica
- Familial adenomatous polyposis
- pancreas
- Insulinoma
- Glucagonoma
- Gastrinoma
- VIPoma
- Somatostatinoma
- Cholangiocarcinoma
- Klatskin tumor
- Hepatocellular adenoma/Hepatocellular carcinoma
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| Urogenital |
- Renal cell carcinoma
- Endometrioid tumor
- Renal oncocytoma
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| Endocrine |
- Prolactinoma
- Multiple endocrine neoplasia
- Adrenocortical adenoma/Adrenocortical carcinoma
- Hurthle cell
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| Other/multiple |
- Neuroendocrine tumor
- Adenoid cystic carcinoma
- Oncocytoma
- Clear cell adenocarcinoma
- Apudoma
- Cylindroma
- Papillary hidradenoma
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Adnexal and
skin appendage (8390-8429) |
- sweat gland
- Syringocystadenoma papilliferum
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Cystic, mucinous,
and serous (8440-8499) |
| Cystic general |
- Cystadenoma/Cystadenocarcinoma
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| Mucinous |
- Signet ring cell carcinoma
- Mucinous cystadenoma / Mucinous cystadenocarcinoma
- Mucoepidermoid carcinoma
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| Serous |
- Ovarian serous cystadenoma / Pancreatic serous cystadenoma / Serous cystadenocarcinoma / Papillary serous cystadenocarcinoma
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Ductal, lobular,
and medullary (8500-8549) |
| Ductal carcinoma |
- Mammary ductal carcinoma
- Pancreatic ductal carcinoma
- Comedocarcinoma
- Paget's disease of the breast / Extramammary Paget's disease
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| Lobular carcinoma |
- Lobular carcinoma in situ
- Invasive lobular carcinoma
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| Medullary carcinoma |
- Medullary carcinoma of the breast
- Medullary thyroid cancer
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| Acinar cell (8550-8559) |
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| Other |
| Complex epithelial (8560-8589) |
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- See also
- Template:Epithelium and epithelial tissue
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UpToDate Contents
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- 1. 異型および上皮内小葉癌：乳癌のハイリスク病変 atypia and lobular carcinoma in situ high risk lesions of the breast
- 2. 乳癌の概要 an overview of breast cancer
- 3. 微小浸潤乳癌 microinvasive breast carcinoma
- 4. 乳癌のTNM病期分類 tumor node metastasis tnm staging classification for breast cancer
- 5. 乳房温存療法後の乳癌局所再発の管理 management of locoregional recurrence of breast cancer after breast conserving therapy
English Journal
- A validation of DCIS registration in a population-based breast cancer quality register and a study of treatment and prognosis for DCIS during 20 years.
- Wadsten C1,2, Heyman H3, Holmqvist M4, Ahlgren J5, Lambe M4,6, Sund M2, Wärnberg F3.
- Acta oncologica (Stockholm, Sweden).Acta Oncol.2016 Nov;55(11):1338-1343. Epub 2016 Aug 22.
- AIMS: Sweden has a long history of population-based cancer registration. The aim of our study was to assess the validity of DCIS registration in a regional Breast Cancer Quality Register (BCQR) and to analyze trends in incidence, treatment and outcome of DCIS, over a 20-year period.MATERIAL AND METH
- PMID 27548561
- When pathological and radiological correlation is achieved, excision of fibroadenoma with lobular neoplasia on core biopsy is not warranted.
- Fives C1, O'Neill CJ2, Murphy R1, Corrigan MA1, O'Sullivan MJ1, Feeley L1, Bennett MW1, O'Connell F1, Browne TJ1.
- Breast (Edinburgh, Scotland).Breast.2016 Oct 3;30:125-129. doi: 10.1016/j.breast.2016.09.006. [Epub ahead of print]
- BACKGROUND: The diagnosis and management of lobular neoplasia (LN) including lobular carcinoma in situ (LCIS) and atypical lobular hyperplasia (ALH) remains controversial. Current management options after a core needle biopsy (CNB) with lobular neoplasia (LN) incorporating both ALH and LCIS include
- PMID 27718416
- Pathologic High-risk Lesions, Diagnosis and Management.
- Murray M1.
- Clinical obstetrics and gynecology.Clin Obstet Gynecol.2016 Sep 27. [Epub ahead of print]
- Percutaneous imaging-guided core needle biopsy (CNB) is a less invasive and less expensive alternative to surgical biopsy for the evaluation of breast lesions. After a CNB the radiologist determine if there is concordance between the pathology, imaging, and clinical findings. Patient management afte
- PMID 27681693
Japanese Journal
- 山岸 陽二,山崎 民大,竹下 卓志,守屋 智之,宮居 弘輔,島崎 英幸,津田 均,長谷 和生,山本 順司
- The Kitakanto medical journal 62(4), 447-447, 2012-11-01
- NAID 120005082437
- SF-088-4 非浸潤性小葉癌(LCIS)の臨床的意義と治療方針(サージカルフォーラム(88)乳腺:画像診断,第111回日本外科学会定期学術集会)
- 大城 泰平,木下 貴之,田村 宣子,長尾 知哉,北條 隆,明石 定子,津田 均,藤原 康弘
- 日本外科学会雑誌 112(臨時増刊号_1・2), 446, 2011-05-25
- NAID 110008684094
- 微小腺管腺症・複雑型硬化性病変を背景とし, 術前診断が困難であった非浸潤性小葉癌と非浸潤性乳管癌が混在した両側乳癌の1例
- 間瀬 隆弘,今井 常夫,野田 純代
- 内分泌外科 = Endocrine surgery 27(3), 227-231, 2010-09-30
- NAID 10029084702
Related Links
- 非浸潤性小葉癌（Lobular carcinoma in situ：LCIS）とはどのような病気なのかについて詳しく解説しています。公益財団法人がん研究会がん研究所病理部臨床病理部長 秋山太先生 | 乳癌診療Tips＆Traps
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