CURRENT TREATMENT FOR LOBULAR CARCINOMA IN-SITU

Background: We thought that observation for patients with lobular carc inoma in situ (LCIS) had been generally accepted by the mid-1980s. A q uestionnaire 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 recirculati ng the 1988 questionnaire. Methods: The identical questionnaire was ma iled to members of the same oncologic societies (Society of Surgical O ncology [SSO] and Society for the Study of Breast Disease), but change s in membership necessitated new mailing lists. Results: Observation h as yet to be universally accepted by the oncologic community, but at t his time 85% of the respondents suggest it as the preferred option for their patients. Conclusions: Recent studies have questioned some of t he tenets laid down by Haagensen in 1978, but it appears clear that hi s formulation of LCIS as a marker of increased risk continues to gain ground over the original concept of inevitable progression to invasive disease.