On April 14, 2015, actress Rita Wilson announced that she had been diagnosed with breast cancer and had undergone a double mastectomy and reconstruction. In addition to invasive cancer, one of her diagnoses was pleomorphic lobular carcinoma in situ (PLCIS).
PLCIS isn’t well-known, and many of my patients wondered what it is and how it’s treated.
PLCIS is a type of lobular carcinoma in situ (LCIS). LCIS is an area (or areas) of abnormal cell growth in the breast lobules, the milk-producing glands at the end of the breast ducts. “In situ” means the abnormal growth is completely inside the lobule and hasn’t spread to surrounding tissues.
With PLCIS, the cells look more abnormal than they do in regular LCIS. Regular LCIS doesn’t spread and doesn’t become cancer, so surgery is rarely recommended. Still, women who have LCIS have a higher risk of invasive breast cancer, so they are usually closely monitored and undergo more frequent screening.
PLCIS is more like high-grade ductal carcinoma in situ (DCIS) — it has a higher risk of becoming invasive cancer. So PLCIS treated the same way as DCIS. Standard treatment options for PLCIS include:
- lumpectomy followed by radiation therapy: this is the most common treatment
- mastectomy: mastectomy is recommended in some cases if there is a strong family history or a woman knows she has an abnormal BRCA1 or BRCA2 gene
- hormonal therapy after surgery: hormonal therapy medicines block or lower the amount of estrogen in the body and are recommended if the PLCIS is hormone-receptor-positive (most are)
After surgery for PLCIS, you and your doctor develop a screening plan that is tailored to your unique situation. If you’re taking hormonal therapy, you should have a physical exam every year because these medicines can increase the risk of other conditions such as osteoporosis and blood clots.
Both LCIS and PLCIS are considered uncommon conditions, and there aren’t many statistics on how many people are diagnosed with the conditions.
