title: Risk counseling and management in patients with lobular carcinoma in situ.
abstract: BACKGROUND
  The understanding of lobular carcinoma in situ (LCIS) has evolved since it was first described. LCIS once was thought to be a premalignant condition, but now it is considered a marker for increased risk for developing invasive breast cancer. We evaluated patient perception of risk, counseling, and subsequent management.
  
  
  METHODS
  A community cancer registry of 3,605 cases of breast cancer was reviewed. Fifty-five (1.5%) patients with LCIS as their sole diagnosis were identified and these patients were sent a questionnaire.
  
  
  RESULTS
  Forty of 55 patients completed the questionnaire for a 73% response rate. The patients' perception of lifetime risk for invasive cancer was variable. Surgeons performed the majority of counseling. Fourteen patients (35%) were placed on a selective estrogen-receptor modulator. Eleven patients (28%) had bilateral mastectomy. Three patients had unilateral mastectomy. Screening recommendations included an annual mammography (64%), a professional examination (64%), and a monthly self-breast examination (75%).
  
  
  CONCLUSIONS
  A patient's perception of risk for invasive breast cancer after a diagnosis of LCIS is widely variable. Patients will adhere to suggested screening recommendations. Surgeons are performing the majority of counseling and must stay abreast on current recommendations.
authors.affiliation: Department of Surgery, Oregon Health and Science University, Portland, OR, USA. garreauj@ohsu.edu
authors.forename: Jennifer R
authors.initials: JR
authors.lastname: Garreau
authors.forename: Joanne
authors.initials: J
authors.lastname: Nelson
authors.forename: Regan
authors.initials: R
authors.lastname: Look
authors.forename: Deb
authors.initials: D
authors.lastname: Walts
authors.forename: Diana
authors.initials: D
authors.lastname: Mahin
authors.forename: Louis
authors.initials: L
authors.lastname: Homer
authors.forename: Nathalie
authors.initials: N
authors.lastname: Johnson
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000473:pathology* / Q000628:therapy; D002278:Carcinoma in Situ / Q000473:pathology* / Q000628:therapy; D018275:Carcinoma, Lobular / Q000473:pathology* / Q000628:therapy; D003376:Counseling; D005260:Female; D006801:Humans; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D010349:Patient Compliance; D012042:Registries; D018570:Risk Assessment; D011795:Surveys and Questionnaires