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LCIS is classically an incidental finding on breast biopsy with no positive mammographic features. However, screening has identified a small number of cases of pure LCIS.
To review cases of screen-detected LCIS within the NHSBSP programme since its inception.
Cases of pure LCIS were identified via Quality Assurance offices and screening centres. Mammograms and pathology were reviewed and recurrence/survival data obtained. New immunohistochemistry was performed on the available pathology blocks.
One hundred and sixty-six cases of screen-detected LCIS were identified in 20 centres since 1988. One hundred and seven (64%) presented with calcifications on mammography, 25 (15%) with a mass lesion and 34 (21%) with distortion or asymmetry. The preoperative diagnosis rate with core biopsy was 28/84 = 33%.
Of 106 patients in which follow-up was available to date, six went on to get an invasive cancer at a median time of 60 months; four of these were unilateral.
Screen-detected LCIS is a rare but important lesion. Preoperative diagnosis is difficult. Invasive recurrence is 1% per year of follow-up.