Pleomorphic lobular carcinoma in situ: treatment options for a new pathologic entity.

Introduction Not only is breast carcinoma the second leading cause of cancer mortality, it is also the most common form of cancer in women. Accumulation of genetic alterations within a single clone of cells eventually leads to uncontrolled growth. Models of progression of breast carcinoma suggest that the epithelial cell gives rise to carcinoma in situ after first going through phases of hyperplasia and atypical hyperplasia. In 1941, lobular carcinoma in situ (LCIS) was first described as a preinvasive lesion with inevitable progression to invasive lobular carcinoma (ILC). Total mastectomy was the standard recommendation. Haagensen, while working at Columbia University, was the first to describe LCIS progressing to ILC. In 1978, Rosen stated that total astectomy with low axillary dissection was the most logical operaive procedure for LCIS and that a contralateral biopsy should be erformed to rule out bilaterality. By the 1980s, LCIS was accepted as a marker for increased risk rather than a precancerous lesion, and