The Breast Cancer Consultation Service
Michael D. Lagios, M.D. • (415) 789-0965

Home
Second Opinion Service
Forms
About Dr. Lagios

Dr. Michael D. Lagios, a nationally recognized breast pathologist and medical director of The Breast Cancer Consultation Service, provides the service and personally discusses the findings with you. He has directed this and similar services in San Francisco since 1980. He is an internationally recognized expert on duct carcinoma in situ and has written or co-authored much of the pertinent literature in this area over the last twenty years. He has been recognized by "Best Doctors in America" (1992-1993, 1994-1995), "Best Doctors, Pacific Region" (1995-1996), Best Doctors in America 1996 - present (www.bestdoctors.com), is an editor for Seminars in Breast Disease, and the Breast Journal, co-editor for Breast Diseases, a Yearbook Quarterly and reviews for Cancer, Breast Cancer Research Treatment, American Journal of Surgical Oncology, Human Pathology and others. He was president of the American Society for Breast Disease from 1998 to 1999 and was on their board of directors from 2000 to 2004. He is an associate clinical professor of pathology at Stanford Medical School.

Dr. Lagios is a San Francisco native and graduated from UCSF in 1965 and has been in private practice in that city since 1972.

Abbreviated Curriculum Vitae for Dr. Michael Lagios
(an expanded CV is available here)

Education
  • University of California, Major in Zoology B.A.; 1956 – 1960 Berkeley,  California
  • University of California, School of Medicine, M.D.; 1961 – 1965, San Francisco, California
  • University of California, Department of Pathology Internship; 1965 –  1966, Los Angeles, California
  • University of California, Department of Pathology Residency; 1966 – 1970, San Francisco, California
Special
Certification
  • Anatomic and Clinical Pathology, 11/7/70.  American Board of Pathology, San Francisco,  California 
Professional
Societies
  • American Board of Clinical Pathologists
  • American Society of Breast Disease (Secretary/Treasurer, 1996; President, 1997-1998);
    Immediate Past President, 1998-2000; Board of Directors, 2000 to 2004)
  • American Society of Integrative Biologists
Recent
Appointments
  • Medical Director.  The Breast Cancer Consultation Service.  Tiburon, California.  2001 - present.
  • St. Mary’s Hospital and Medical Center.  Director, Breast Services.  2001 - present.
  • St. Mary’s Hospital and Medical Center.  Medical Director, Breast Cancer Consultation Service. San Francisco, California.  1994 - 2001.
  • California Pacific Medical Center (formerly Children’s Hospital of San Francisco), Staff Pathologist.  1972 - 1994.
  • California Pacific Medical Center, Pathologist to the Breast Health Center, 1988 - 1994.
University
Appointments
  • Assistant Clinical Professor of Pathology, University of California; 1975 – present San Francisco Medical Center, San Francisco, California
  • Clinical Associate Professor of Pathology, Stanford University; 1991 – present Medical Center, Stanford, California
Honors
  • Best Doctors On Line, 1996 – Present (www.bestdoctors.com)
  • Best Doctors of America. Woodward/White; 1992 – 1993 and 1994 – 1995 Editions. 
  • Best Doctors of America, Woodward/White; 1996 – 1997, Edition Pacific Region:
  • Chairman, Breast Cancer Pathology Network; 1976 – 1979, West Coast Cancer Foundation, San Francisco, California
  • Research Associate, Steinhart Aquarium; 1975 – 1981 California Academy of Sciences, San Francisco, California
  • Recipient, Annual Teaching Award in Surgery; 1977 and 1982 Children’s Hospital of San Francisco, California (Awarded by UCSF Surgery Residents)
  • Fellow, California Academy of Sciences; 1978 – Present, San Francisco, California
Pathology Bibliography
Lagios MD. 1974.  Hormonally enhanced proliferation of human breast cancer in organ culture.  An in vitro system for assessment of specific hormonal response.  Oncology, 29: 22-23.
Lagios MD. 1977.  Multicentricity of breast carcinoma demonstrated by routine correlated serial subgross and radiographic examination.  Cancer, 40: 1726-1734.
Lagios MD. 1977.  Therapeutic consideration for non-invasive (in situ) breast carcinoma.  What’s new in cancer care.  Published by the West Coast Cancer Foundation, October, 1977.
Lagios MD, Gates EA, Westdahl PR, Richards V and Alpert BS. 1979.   A guide to the frequency of nipple involvement in breast cancer based on a study of 149 consecutive mastectomies studied in a serial subgross and correlated radiographic technique.  Am J Surg, 138: 135-142.
Lagios MD, Rose MR and Margolin FR. 1980.  Tubular carcinoma of the breast.  Association with multicentricity, bilaterality and family history of breast carcinoma.  Am J Clin Pathol, 73: 25-30.
Friedman MA, Hoffman PG Jr., Dandolos EM, Lagios MD, et.al. 1981.  Estrogen receptors in male breast cancer. Clinical and pathological correlations.  Cancer, 47: 134-137.
Lagios MD. 1981.  Breast pathology with reference to breast reconstruction.  In: Reconstructive Breast Surgery, W. Gant, Editor.  W.B. Saunders, Philadelphia.
Lagios MD, Westdahl PR and Rose MR.  1981.  The concept and implications of multicentricity in breast carcinoma.  Pathology Annual, 16: 87-102.
Lagios MD, Westdahl PR, Margolin FR and Rose MR. 1982.  Duct carcinoma in situ.  Relationship of extent of noninvasive disease to the frequency of occult invasion, multicentricity, lymph node metastases, and short-term failures.  Cancer, 50: 1309-1314.
Lagios MD.  1982.  Estrogen Receptors: Significance and Current Status.  In: Frontiers of Radiation Therapy and Oncology.  Conservative Surgery and Radiation Therapy in the Treatment of Operable Breast Cancer.  J. M. Vaeth, Editor.  Karger, Basel, Switzerland.
Lagios MD, Richards VE, Rose MR and Yee E.  1983.  Segmental mastectomy without radiotherapy.  Short term followup.  Cancer, 52: 2173-2179.
Lagios MD.  1983.  Human Breast Precancer:  Current Status.  In:  Cancer Surveys.  L.M. Franks, Editor, Oxford University Press.  London.
Lagios MD, Westdahl PR, Rose MR and Stasko-Concannon S.  1984.  Paget’s disease of the nipple: Alternative management in cases without or with minimal extent of underlying breast carcinoma.  Cancer, 54: 167-173.
Margolin FR and Lagios MD.  1986.  Mammographic detection of early breast cancer – ten years’ experience in a community hospital.  West J Med, 144: 46-48.
Margolin FR and Lagios MD.  1987.  Development of m;ammography and breast services in a community hospital.  Rad Clin of North America, 25: 973-982.
Lagios MD.  1988.  Paget’s Disease of the Breast.  In: Textbook of Uncommon Cancer.  CJ Williams, JG Krikorian, MR Green and D Raghaven, Editors.  John Wiley & Sons, New York.
Lagios MD, Margolin FR, Westdahl PR, Rose MR.  1989.  Mammographically detected duct carcinoma in situ:  Frequency of local recurrence following tylectomy and prognostic effect of nuclear grade on local recurrence.  Cancer, 63: 618-624.
Lagios MD.  1990.  Duct Carcinoma in situ.  Pathology and Treatment. 
Surgical Clinics of North America, 70 (4).
Lagios MD and Bennington JL.  1991.  Protocol for the Pathologic Examination and Tissue Processing of the Mammographically Directed Breast Biopsy.  In:  Pathology:  State of the Art Reviews.  JL Bennington and MD Lagios, Editors.  Hanley & Belfus. Philadelphia.
Van Dongen JA, Holland R, Peterse JL, Fentiman IS, Lagios MD, Millis RR and Recht A.  1992.  Ductal Carcinoma in situ of the Breast; Second EORTC Consensus Meeting.  Eur J Cancer, 28: 626-629.
Lagios MD.  1992.  Pathologic Features Related to Local Recurrence Following Lumpectomy and Irradiation.  In:  Seminars in Surgical Oncology.  Wiley-Liss, 8: 122-128.
Lagios MD and Page DL.  1993.  Letter to the Editor:  "Radiation Therapy for In Situ or Localized Breast Cancer".  N Eng J Med, 329: 1577-1578.
Lagios MD.  1993.  Heterogeneity of ductal carcinoma in situ of the breast.  J Cellular Biochemistry.  Chemoprevention of Breast Cancer:   Surrogate Endpoints and Agents in Short-Term Clinical Trials.  Supplement 17 G, 49-52.
Page DL and Lagios MD.  1994.  Pathololgy and clinical evolution of ductal carcinoma in situ (DCIS) of the breast.  Cancer Letters, 86: 1-4.
Page DL and Lagios MD.  1995.  Pathologic analysis of the National Surgical Adjuvant Breast Project (NSABP) B-17 Trial:  Unanswered questions remaining unanswered considering current concepts of ductal carcinoma in situ.  Cancer, 75: 1219-1222.
Lagios MD.  1995.  Ductal carcinoma in situ:  Controversies in diagnosis, biology and treatment.  The Breast Journal, 1:68-78.
Lagios MD.  1996.  Duct carcinoma in situ:  Biological implications for clinical practice.  Seminars in Oncology, 23 (Suppl 2): 6-11.
 Lagios MD.  1996.  Pathologic faux pas in breast cancer interpretation.  Path Case Reviews, 
1:41-43.
Lagios MD. 1996.  Classification of duct carcinoma in situ (DCIS) with a characterization of high grade lesions:  Defining cohorts for chemoprevention trials.  J Cell Biochem, 255: 108-111.
Silverstein MJ, Lagios MD, Craig PH, Waisman JR, et.al.  1996.  A prognostic index for ductal carcinoma in situ of the breast.  Cancer, 77: 2267-2274.
Lagios MD.  1997.  Pathologic procedures for mammographically detected ductal carcinoma in situ.  In:  Duct Carcinoma In Situ of the Breast.   M. Silverstein, Editor.  Williams & Wilkins, Philadelphia. pp 189-194.
Lagios MD.  1997.  Grading of ductal carcinoma in situ.  In:  Duct Carcinoma In Situ of the Breast.  M. Silverstein, Editor.  Williams & Wilkins, Philadelphia.  pp 227-232.
Lagios MD.  1997.  Microinvasion in ductal carcinoma in situ.  In:  Duct Carcinoma In Situ of the Breast.  M. Silverstein, Editor.  Williams & Wilkins, Philadephia.  pp 241-246.
Lagios MD.  1997.  The Lagios Experience:  In:  Duct Carcinoma In Situ of the Breast. 
M. Silverstein, Editor. Williams & Wilkins, Philadephia.  pp 361-367.
Lagios MD.  1997.  Lobular carcinoma in situ:  An additional perspective. In:  Duct Carcinoma In Situ of the Breast.  M. Silverstein, Editor.  Williams & Wilkins, Philadephia.  pp 611-616.
Silverstein MJ and Lagios MD.  1997. Use of predictors of recurrence to plan therapy for DCIS of the breast.  Oncology, 11: 393-409.
Lagios MD and Silverstein MJ.  1997.  Ductal carcinoma in situ.  The success of breast conservation therapy:  A shared experience of two single institutional nonrandomized prospective studies.  Surg Oncol Clinics of N Amer, 6: 385-392.
Scott MA, Lagios MD, Axelsson K, et.al.  1997.  Ductal carcinoma in situ of the breast: Reproducibility of histological subtype analysis. Human Path, 28: 967-973.
Lagios MD.  1998.  Prognostic features of breast carcinoma from stereotactic biopsy material. 
In: Seminars in Breast Disease: Radiologic, Pathologic and Surgical Considerations.  Stephen Feig, Editor.  Saunders, Philadelphia.  In press.
Lagios MD.  1998. The contribution of Pathology to breast cancer malpractice:  Common sources of potentially damaging errors in current pathology practice. In: Seminars in Breast Disease: Radiologic, Pathologic and Surgical Considerations.  Stephen Feig, Editor.  Saunders, Philadelphia.  In press.
Lagios MD and Page DL.  1998.  In situ carcinomas of the breast:  Duct carcinoma in situ, Paget’s Disease, lobular carcinoma in situ.  In:  The Breast.  Comprehensive Management of Benign and Malignant Disease.  Kirby Bland, Editor.  Saunders.  In press.
Silverstein MJ, Lagios MD, Martino S, et.al.  1998.  Outcome after invasive recurrence in patients with ductal carcinoma in situ of the breast.  J Clin Oncol, 16: 1367-1373.
Silverstein MJ, LaGios MD, Groshien S, Waisman JR, et.al.  1999.  The influence of margin width on local control of ductal carcinoma in situ of the breast.  N Engl J Med, 30: 1455-1461.
Sneige N, Lagios MD, Schwarting R, Colburn W, et.al.  1999.  Interobserver reproducibility of the Lagios nuclear grading sytem for ductal carcinoma in situ.  Human Pathol. 30:257-262.
Lagios MD.  1999.  Ductal Carcinoma In Situ—Sifting Wheat from Chaff.  What Every Woman Should Know.  In:  The Community Breast Health Project (CBHP) Report.  Vol. 6, Issue 2, pp 1, 8-9.
Lagios MD.  2000. Pathology procedures for evaluation of the specimen with potential or documented DCIS.  Seminars in Breast Disease, 3: 42-49.
Lagios MD.  2003.  DCIS: Current concepts in diagnosis and management.  The Breast Journal, 9, suppl: 22-24.
Meng ZH, Ben Y, Li Z, Chew K, Ljung B, Lagios MD, Dirkee SH.  2004.  Aberrations of breast cancer susceptibility genes occur early in sporadic breast tumors and in acquisition of breast epithelial immortalization.  Gen Cheom Canc, 41: 214-222.
Romero L, Klein L, Wei Y, Holmes D, Soni R, Silberman H, Lagios MD and Silverstein MJ.  2004.  Outcome after invasive recurrence in patients with ductal carcinoma in situ of the breast.  Am J Surg.  188: 371-376.
Silverstein MJ, Lagios MD, Recht A, et al.  2005.  Image-detected breast cancer:  State of the art diagnosis and treatment.  J Amer Coll Surg. 201(4): 586-97.
Lagios MD. 2006.  Problems in the assessment of tumor size:  An elusive grail in current practice.  Seminars in Breast Disease, 8: 24-30.
Macdonald HR.  Silverstein MJ, Lee LA, Ye W, Sanghavi P, Holmes DR, Silberman H, Lagios, M.  2006.  Margin width as the sole determinant of local recurrence after breast conservation in patient with ductal carcinoma in situ of the breast.  Am J Surg, 291:  420-422.
Lee LA, Silverstein MJ, Chung CT, Macdonald H, Sanghavi P, EEpstein M, Holmes DR, Silberman H, Ye W, Lagios MD.  2006.  Breast cancer-specific mortality after invasive local recurrence in patients with ductal carcinoma in situ of the breast.  Am J Surg, 192: 416-419.
The Breast Cancer Consultation Service • Michael D. Lagios, M.D. • P.O. Box 950, Tiburon, California, 94920
Phone (415) 789-0965 • Fax (415) 435-2293