‘Pre-invasive’ breast cancer is the name for abnormal cells or cancer cells that stay inside the milk ducts or milk sacs (lobules) of the breast. Ductal carcinoma in situ (DCIS) and lobular carcinoma in situ (LCIS) are types of pre-invasive breast cancer. Invasive breast cancer is the name for cancer cells that have spread outside the milk ducts or milk sacs into the surrounding breast tissue. Invasive breast cancer cells have the potential to spread outside the breast to other parts of the body. Early breast cancer, locally advanced breast cancer, and metastatic breast cancer are all types of invasive breast cancer.
Ductal carcinoma in situ (DCIS)
DCIS is the name for cancer cells that stay inside the milk ducts of the breast. DCIS is sometimes called ‘non-invasive breast cancer’, a ‘pre-cancer’ or an ‘intraductal cancer’.
DCIS is usually found by routine breast screening with mammograms. Most women are not aware of any symptoms at the time of diagnosis.
Having DCIS increases your risk (chance) of developing invasive breast cancer. It’s important to treat your DCIS, to lower your risk of developing invasive breast cancer.
More information on DCIS is available on this site.
Lobular carcinoma in situ (LCIS), Atypical lobular hyperplasia (ALH) and Atypical ductal hyperplasia (ADH)
To understand LCIS, ALH and ADH, it helps to know what your breast looks like on the inside. The breast contains lobules (milk sacs), which produce milk when a woman breastfeeds her baby. The milk travels from the lobules to the nipple through milk ducts. These ducts are surrounded by fatty tissue.
Sometimes, cells on the inside of the lobules or ducts become abnormal
in shape and size and begin to multiply in an uncontrolled way.
If the abnormal cells stay inside the lobules in the breast this is called LCIS or ALH. In LCIS, there are more abnormal cells in the lobule than in ALH. If the abnormal cells stay inside the ducts in the breast, this is called ADH. There is another pre-invasive breast disease called ductal carcinoma in situ (DCIS) that affects the breast ducts. However, in DCIS there are more abnormal cells in the duct than in ADH and some DCIS cells look and behave differently.
How are LCIS ALH and ADH found?
LCIS, ALH and ADH cannot be felt as a breast lump or other breast change, and only sometimes show up on a mammogram image (X-ray of the breast). These conditions are usually found by chance when a woman has a breast biopsy (removal of some tissue from the breast) for some other reason.
What does a diagnosis of LCIS ALH or ADH mean?
Most women diagnosed with these conditions do not develop breast cancer. It is not possible to say exactly how much higher your risk of developing breast cancer is. Studies have shown that the risk of developing breast cancer is about four times higher for women with ALH or ADH compared with women who do not have ALH or ADH. The risk of developing breast cancer is up to nine times higher for women with LCIS compared with who do not have LCIS. Each woman’s risk is also affected by other things, such as her age, and whether she has a family history of breast cancer. Talk to your doctor or breast care nurse about your risk of developing breast cancer.
Do I need treatment for LCIS ALH or ADH?
If you have LCIS, ALH or ADH and there are no other abnormal changes in your breast, you do not need treatment.
However, because of the increased risk of breast cancer, it’s important to have regular check-ups, which should be arranged through your doctor. Your regular check-ups will include:
- physical examination of both breasts by your doctor once a year
- a mammogram and/or ultrasound of both breasts once a year.
If you notice any changes in your breasts, such as a breast lump, a change in the shape, texture or skin of your breast, or a change to your nipple, do not wait until your next appointment. See your doctor straight away.
For more information, an NBCC* resource is available Lobular carcinoma in situ and atypical hyperplasias of the breast: understanding your diagnosis (181kb pdf).
* In February 2008, National Breast Cancer Centre (NBCC) changed its name to National Breast and Ovarian Cancer Centre (NBOCC).
