title: [How to explore breast skin lesion?: Guidelines].
abstract: A change in the shape or appearance of the nipple-areola complex, especially if it is unilateral and recent appearance, is a sign of underlying breast tumor. Breast imaging is then required (grade C). Any erythematous lesion of the nipple or nipple-areola can be a Paget's disease, an adenoma of the nipple or a nipple eczema. Clinical course and pattern can point to a diagnosis without sufficient specificity (LE4). If nipple eczema is suspected, it is recommended to perform a test treatment with topical corticosteroids. In case of failure or if a Paget's disease of the breast is suspected, a biopsy must be done. When indicated, it is not possible to recommend a biopsy modality (scrape cytology, punch biopsy, nipple core biopsy and surgical excision) compared to another. When imaging exploration of the nipple-areola complex is necessary, ultrasound and mammography are recommended as first-line. In the absence of signal, an MRI is recommended as second-line (grade C).
authors.affiliation: Service de chirurgie gynécologique, cancérologie gynécologique et mammaire, clinique de gynécologie, hôpital Jeanne-de-Flandre, CHRU de Lille, avenue Eugène-Avinée, 59037 Lille cedex, France. Electronic address: loic.boulanger@chru-lille.fr.
authors.forename: L
authors.initials: L
authors.lastname: Boulanger
authors.affiliation: Service de chirurgie gynécologique, cancérologie gynécologique et mammaire, clinique de gynécologie, hôpital Jeanne-de-Flandre, CHRU de Lille, avenue Eugène-Avinée, 59037 Lille cedex, France.
authors.forename: J
authors.initials: J
authors.lastname: Demetz
mesh_terms: D001941:Breast Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging; D004485:Eczema / Q000175:diagnosis* / Q000188:drug therapy; D005260:Female; D006801:Humans; D009558:Nipples / Q000473:pathology*; D017410:Practice Guidelines as Topic; D011859:Radiography
keywords: Dermatose; Dermatosis; Eczema; Eczéma; Maladie de Paget du mamelon; Nipple-areola complex; Paget's disease of the nipple; Plaque aréolomamelonnaire