title: [Benign proliferative breast disease with and without atypia].
abstract: In the last few years, diagnostics of high-risk breast lesions (atypical ductal hyperplasia [ADH], flat epithelial atypia [FEA], lobular neoplasia: atypical lobular hyperplasia [ALH], lobular carcinoma in situ [LCIS], radial scar [RS], usual ductal hyperplasia [UDH], adenosis, sclerosing adenosis [SA], papillary breast lesions, mucocele-like lesion [MLL]) have increased with the growing number of breast percutaneous biopsies. The management of these lesions is highly conditioned by the enlarged risk of breast cancer combined with either an increased probability of finding cancer after surgery, either a possible malignant transformation (in situ or invasive cancer), or an increased probability of developing cancer on the long range. An overview of the literature reports grade C recommendations concerning the management and follow-up of these lesions: in case of ADH, FEA, ALH, LCIS, RS, MLL with atypia, diagnosed on percutaneous biopsies: surgical excision is recommended; in case of a diagnostic based on vacuum-assisted core biopsy with complete disappearance of radiological signal for FEA or RS without atypia: surgical abstention is a valid alternative approved by multidisciplinary meeting. In case of ALH (incidental finding) associated with benign lesion responsible of radiological signal: abstention may be proposed; in case of UDH, adenosis, MLL without atypia, diagnosed on percutaneous biopsies: the concordance of radiology and histopathology findings must be ensured. No data is available to recommend surgery; in case of non-in sano resection for ADH, FEA, ALH, LCIS (except pleomorphic type), RS, MLL: surgery does not seem to be necessary; in case of previous ADH, ALH, LCIS: a specific follow-up is recommended in accordance with HAS's recommendations. In case of FEA and RS or MLL combined with atypia, little data are yet available to differ the management from others lesions with atypia; in case of UDH, usual sclerosing adenosis, RS without atypia, fibro cystic disease: no specific follow-up is recommended in agreement with HAS's recommendations.
authors.affiliation: Département d'oncologie chirurgicale, centre de lutte contre le cancer Georges-François-Leclerc - Unicancer, 1, rue Professeur-Marion, BP 77980, 21079 Dijon cedex, France; Université de Bourgogne-Franche Comté, esplanade Erasme, 21078 Dijon cedex, France. Electronic address: ccoutant@cgfl.fr.
authors.forename: C
authors.initials: C
authors.lastname: Coutant
authors.affiliation: Inserm UMRS938, service de gynécologie obstétrique et médecine de la reproduction, hôpital Tenon, AP-HP, 4, rue de la Chine, 75020 Paris, France.
authors.forename: G
authors.initials: G
authors.lastname: Canlorbe
authors.affiliation: Inserm UMRS707, service de gynécologie obstétrique et médecine de la reproduction, hôpital Tenon, AP-HP, 4, rue de la Chine, 75020 Paris, France.
authors.forename: S
authors.initials: S
authors.lastname: Bendifallah
authors.affiliation: Université de Bourgogne-Franche Comté, esplanade Erasme, 21078 Dijon cedex, France; Département de pathologie des tumeurs, centre de lutte contre le cancer Georges-François-Leclerc - Unicancer, 1, rue Professeur-Marion, BP 77980, 21079 Dijon cedex, France.
authors.forename: F
authors.initials: F
authors.lastname: Beltjens
mesh_terms: D001941:Breast Diseases / Q000145:classification / Q000175:diagnosis* / Q000628:therapy*; D005260:Female; D006801:Humans; D017410:Practice Guidelines as Topic
keywords: Adenosis; Adénose; Atypical ductal neoplasia; Cicatrices radiaires; Flat epithelial atypia; High-risk breast lesion; Hyperplasie canalaire atypique; Lobular neoplasia; Lésions frontières du sein; Lésions prolifératives apocrines; Mucocèles; Métaplasie cylindrique avec atypie; Néoplasies lobulaires; Papillary breast lesions; Proliférations épithéliales sans atypie; Radial scar; Sclerosing adenosis