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Does finding a positive surgical margin containing pleomorphic LCIS in a patient with early-stage invasive ductal carcinoma of the breast affect your management in regards to breast conservation therapy?

Would you recommend re-excision of a positive margin containing only pleomorphic LCIS prior to radiation for BCS? Does the presence of this rare histology affect your typical management of DCIS or early stage IDC?
2 Answers
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Radiation Oncology · Varian Medical Systems/Allegheny health network
Answered on

Based on limited data, we treat PLCIS with the same principal as DCIS and aim for a negative margin and offer adjuvant RT. PLCIS presents with microcalcs like DCIS and in the pre e-cadherin staining era, they were called DCIS and included in the old NSABP study as DCIS.

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Mednet Member
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Radiation Oncology · Rutgers Robert Wood Johnson Medical School
Answered on

There is much confusion about pleomorphic LCIS, how it is classified, and how it should be treated. It has been suggested that it behaves more like DCIS and therefore should be treated as such. Some have advocated that even for a diagnosis of strictly pleomorhpic LCIS, it should be excised and irrad...

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