Tumeurs bénignes du sein : recommandations pour la pratique clinique du Collège national des gynécologues et obstétriciens français (CNGOF) – Texte court [Benign breast tumors: Recommendations of Collège National des Gynécologues Obstétriciens Français (CNGOF) – Short text]

V. Lavoue (1, 2) , X. Fritel (3, 4, 5) , M. Antoine (6, 7) , F. Beltjens (8) , S. Bendifallah , M. Boisserie-Lacroix , L. Boulanger (9, 10) , G. Canlorbe , S. Catteau-Jonard , N. Chabbert-Buffet , F. Chamming'S , E. Chéreau (11) , J. Chopier (7) , C. Coutant (8) , J. Demetz , N. Guilhen , R. Fauvet , O. Kerdraon , E. Laas , G. Legendre , C. Mathelin (12) , C. Nadeau (13) , I. Thomassin Naggara , C. Ngo (14) , Lobna Ouldamer (15) , A. Rafii (16) , M. -N. Roedlich , J. Seror , J. -Y. Séror , C. Touboul , C. Uzan (17) , E Darai (18, 19)

1 OSS - Oncogenesis Stress Signaling
2 CHU Pontchaillou [Rennes]
3 Service de gynécologie et obstétrique [Poitiers]
4 CESP - Centre de recherche en épidémiologie et santé des populations
5 CIC - Poitiers
6 Theranoscan
7 CHU Tenon [AP-HP]
8 UNICANCER/CRLCC-CGFL - Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon]
9 UNICANCER/Lille - Centre Régional de Lutte contre le Cancer Oscar Lambret [Lille]
10 Hôpital Jeanne de Flandres
11 Institut Paoli-Calmettes
12 Pole of Obstetrics and Gynaecology, Senology Unit
13 CHU Poitiers - Centre hospitalier universitaire de Poitiers
14 HEGP - Hôpital Européen Georges Pompidou [APHP]
15 N2C - Nutrition, croissance et cancer (U 1069)
16 UMR 1203 - Développement embryonnaire précoce humain et pluripotence EmbryoPluripotency
17 CHU Saint-Antoine [AP-HP]
18 Service de Gynécologie-obstétrique et médecine de la reproduction - Maternité [CHU Tenon]
19 UPMC - Université Pierre et Marie Curie - Paris 6

Breast sonography is required with mammogram to explore clinical breast mass (grade B), colored unipore breast nipple discharge (grade C), or mastitis (grade C). Bi-RADS system is recommended to describe and classify breast-imaging abnormalities. For breast abscess, a percutaneous biopsy is recommended in case of mass or persistent symptoms (grade C). For mastodynia, when breast imaging is normal, no MRI neither breast biopsy is recommended (grade C). Percutaneous biopsy is recommended for BI-RADS 4-5 mass (grade B). For persistent erythematous breast nipple or atypical eczema lesion, a nipple biopsy is recommended (grade C). For distortion and asymmetry, a vacuum core needle biopsy is recommended because of the risk of underestimation by simple core needle biopsy (grade C). For BI-RADS 4-5 microcalcifications without ultrasound signal, a vacuum core needle biopsy of at least 11 gauges is recommended (grade B); in the absence of microcalcifications on radiograph carrots, additional samples are recommended (grade B). For atypical ductal hyperplasia, atypical lobular hyperplasia, lobular carcinoma in situ, flat epithelial with atypia, radial scar, mucocele with atypia, surgical excision is commonly recommended (grade C). Expectant management is feasible after multidisciplinary concertation. For these lesions, when excision is not in sano, no new excision is recommended except for pleomorphic or with necrosis CLIS (grade C). For grade 1 phyllode tumour, in sano surgical resection is recommended; for grade 2 phyllode, 10-mm margins are recommended (grade C). For breast papillary without atypia, complete disappearance of the radiologic signal is recommended (grade C). For breast papillary with atypia, complete surgical excision is recommended (grade C).

Keywords: ésTumeur bénigne du sein; Échographie; Benign breast tumour; Sonography; Mammogram; Histologie; Mammographie; Pathological analysis; Classification BI-RADS; BI-RADS classification

Domains: Life Sciences [q-bio]

V. Lavoue, X. Fritel, M. Antoine, F. Beltjens, S. Bendifallah, et al.. Tumeurs bénignes du sein : recommandations pour la pratique clinique du Collège national des gynécologues et obstétriciens français (CNGOF) – Texte court [Benign breast tumors: Recommendations of Collège National des Gynécologues Obstétriciens Français (CNGOF) – Short text]. Journal de Gynécologie Obstétrique et Biologie de la Reproduction, 2015, 44 (10), pp.1049-1064. ⟨10.1016/j.jgyn.2015.09.033⟩. ⟨hal-01225494⟩