Current treatment for lobular carcinoma in situ

Background: We thought that observation for patients with lobular carcinoma in situ (LCIS) had been generally accepted by the mid-1980s. A questionnaire mailed to oncologic surgeons in 1988 revealed that 33% of the respondents still advised unilateral mastectomy, although a slim majority (54%) advised observation. New studies have been published in the intervening 8 years, and we decided it would be worth recirculating the 1988 questionnaire. Methods: The identical questionnaire was mailed to members of the same oncologic societies (Society of Surgical Oncology [SSO] and Society for the Study of Breast Disease), but changes in membership necessitated new mailing lists. Results: Observation has yet to be universally accepted by the oncologic community, but at this time 85% of the respondents suggest it as the preferred option for their patients. Conclusions: Recent studies have questioned some of the tenets laid down by Haagensen in 1978, but it appears clear that his formulation of LCIS as a marker of increased risk continues to gain ground over the original concept of inevitable progression to invasive disease.