How do you decide when to offer radiation therapy for pleomorphic lobular carcinoma in situ after lumpectomy?

There is limited data, but it appears pleomorphic LCIS behaves like DCIs presenting as microcars, with increased risk of index site recurrence or progression.

Based on this research we tend to treat like high grade DCIS following the same principal.

In older studies (NSABP) because e cadh IHC testing...

The data on this subject are limited and contradictory. However, I believe that PLCIS behaves like high-grade DCIS much more than it behaves like classic LCIS. Therefore, I recommend postoperative radiation for all patients with PLCIS, which is the same as my policy for DCIS of nuclear grade 3.