Lobular carcinoma in situ remains controversial in nomenclature, histology, and therapy. The original description and therapeutic recommendations remain a significant contribution to better control of breast cancer. We believe the sophistication of mammography, not available at the time of the earliest therapeutic recommendations, provides the clinician with a valuable and accurate new diagnostic tool for this disease. The risk factors from this disease entity have been well outlined by McDivitt [1] and others. We believe the patient should permitted to participate in the therapeutic decision after proper education about the risk factors of cancer in the ipsilateral and contralateral breast. Patients have requested bilateral mastectomies; some of these patients then wanted plastic reconstruction. Many others, however, have no such interest. The properly informed and responsible patient who elects to have close observation, with mammograms every six months, we feel has elected an acceptable clinical strategy for this disease.