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ABSTRACT: Lobular Carcinoma In Situ and Invasive Cancer: The Contralateral
Breast Controversy
We determined if the risk of relapse is increased in patients
with the concomitant diagnosis of lobular carcinoma in situ
(LCIS) and an invasive cancer, suggesting the need for a more
aggressive surgical approach.
A retrospective chart review was
conducted from the University of Michigan's Cancer Registry of
patients with LCIS and a simultaneous invasive cancer and patients
with invasive cancer only diagnosed between 1981 and 1997.
The
two groups were compared statistically with the following
variables: age at diagnosis, tumor stage, histopathologic type
of cancer, type of surgery, first line of treatment, relapse
status with dates, site of relapse, and vital status. Statistically
significant differences were found in the distribution of age
(mean p = 0.0484 and median p = 0.0216), and histopathologic type
of cancer (p< 0.0001).
No significant difference was noted in the
overall survival between the two groups (p = 0.511). There was
also a significant difference in the relapse-free survival curves
between the groups (p = 0.032). The risk of relapse was almost
double (1.92) for the cancer-only patients relative to patients
with LCIS as a histologic component of cancer.
There was no
significant increase in contralateral or ipsilateral breast
recurrence for patients with LCIS and an invasive cancer compared
to an invasive cancer alone.
This lends support to the use of
breast conservation therapy for invasive cancer patients with a
histologic component of LCIS.
The significant difference in the
types of cancer may support the theory of genetic progression of
LCIS to cancer, but clearly further data are required to prove
this hypothesis.
[09/06/2002; The Breast Journal]
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