The proper treatment for lobular carcinoma in situ (LCIS) includes which of the following components?

A. Close follow-up.

DISCUSSION: LCIS is best thought of as a precursor lesion that confers increased risk for eventual cancer. The magnitude of this risk appears to be in the range of seven- to ninefold over baseline risk. The chance of breast cancer is equal in both breasts, not just in the biopsied breast, and the type of cancer is not confined to a lobular histology. After a diagnosis of LCIS, patients are at increased risk for invasive and noninvasive ductal carcinoma in both breasts. Therefore, mirror-image biopsy as practiced in the past has little to offer. Since LCIS is purely noninvasive, nodal dissection is not required if mastectomy is chosen. There are no data on the use of breast radiation therapy for LCIS. Most surgical oncologists recommend close follow-up for patients who have LCIS only; the alternative surgical treatment that makes most sense is bilateral simple mastectomies, with or without reconstruction.