DCIS and LCIS: Are the Risk Factors for Developing In Situ Breast Cancer Different?

SIMPLE SUMMARY: Ductal carcinoma in situ (DCIS) is recognised as a precursor to invasive breast cancer (IBC), while lobular carcinoma in situ (LCIS) is considered a risk factor for subsequent IBC. To investigate whether the factors that increase the risks of DCIS and LCIS also predispose to IBC, we analysed risk factors for 3075 DCIS cases, 338 LCIS cases, and 1584 controls aged 35–60. Results showed that breastfeeding after childbirth decreased risks of DCIS and LCIS, similar to the association with IBC. Post-menopausal hormone replacement therapy (HRT) increased the risks of DCIS and LCIS, especially in long-term use (10+ years), with a stronger association with LCIS. However, neither parity nor an increasing number of births decreased the risks of DCIS or LCIS, as they do IBC. The study shows both similarities and differences in the risk factors affecting in situ breast cancer and IBC, and results suggest that regular surveillance is warranted in post-menopausal women taking long-term HRT. ABSTRACT: Ductal carcinoma in situ (DCIS) is widely accepted as a precursor of invasive ductal carcinoma (IDC). Lobular carcinoma in situ (LCIS) is considered a risk factor for invasive lobular carcinoma (ILC), and it is unclear whether LCIS is also a precursor. Therefore, it would be expected that similar risk factors predispose to both DCIS and IDC, but not necessarily LCIS and ILC. This study examined associations with risk factors using data from 3075 DCIS cases, 338 LCIS cases, and 1584 controls aged 35–60, recruited from the UK-based GLACIER and ICICLE case-control studies between 2007 and 2012. Analysis showed that breastfeeding in parous women was protective against DCIS and LCIS, which is consistent with research on invasive breast cancer (IBC). Additionally, long-term use of HRT in post-menopausal women increased the risk of DCIS and LCIS, with a stronger association in LCIS, similar to the association with ILC. Contrary to findings with IBC, parity and the number of births were not protective against DCIS or LCIS, while oral contraceptives showed an unexpected protective effect. These findings suggest both similarities and differences in risk factors for DCIS and LCIS compared to IBC and that there may be justification for increased breast surveillance in post-menopausal women taking long-term HRT.