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Summary of consensus practice points
- 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.
- Surveillance includes annual clinical examination and bilateral imaging, subject to specialist clinical judgement (e.g. considering the age of the woman).
- If LCIS of the classic variant is found in isolation or as an incidental finding (on core needle or excision biopsy), with pathological-radiological concordance, then surveillance remains an option.
- If PLCIS is found on core needle biopsy, excision should be performed.
- If other sub-types of LCIS (such as classic LCIS with comedo-type necrosis and florid/bulky LCIS) are found on core needle biopsy, excision may be considered.
- There is no evidence to support the use of radiotherapy for LCIS in general, but adjuvant radiotherapy may be considered for women with PLCIS.
- Risk-reducing medication, including aromatase inhibitors or selective oestrogen receptor modulators, is an option for preventing invasive breast cancer, subject to an individual woman’s overall clinical profile.