title: Clinical practice guidelines from the French College of Gynecologists and Obstetricians (CNGOF): benign breast tumors - short text.
abstract: Screening with breast ultrasound in combination with mammography is needed to investigate a clinical breast mass (Grade B), colored single-pore breast nipple discharge (Grade C), or mastitis (Grade C). The BI-RADS system is recommended for describing and classifying abnormal breast imaging findings. For a breast abscess, a percutaneous biopsy is recommended in the case of a mass or persistent symptoms (Grade C). For mastalgia, when breast imaging is normal, no MRI or breast biopsy is recommended (Grade C). Percutaneous biopsy is recommended for a BI-RADS category 4-5 mass (Grade B). For persistent erythematous nipple or atypical eczema lesions, a nipple biopsy is recommended (Grade C). For distortion and asymmetry, a vacuum core-needle biopsy is recommended due to the risk of underestimation by simple core-needle biopsy (Grade C). For BI-RADS category 4-5 microcalcifications without any ultrasound signal, a minimum 11-G vacuum core-needle biopsy is recommended (Grade B). In the absence of microcalcifications on radiography cores additional samples are recommended (Grade B). For atypical ductal hyperplasia, atypical lobular hyperplasia, lobular carcinoma in situ, flat epithelial atypia, radial scar and mucocele with atypia, surgical excision is commonly recommended (Grade C). Expectant management is feasible after multidisciplinary consensus. For these lesions, when excision margins are not clear, no new excision is recommended except for LCIS characterized as pleomorphic or with necrosis (Grade C). For grade 1 phyllodes tumor, surgical resection with clear margins is recommended. For grade 2 phyllodes tumor, 10mm margins are recommended (Grade C). For papillary breast lesions without atypia, complete disappearance of the radiological signal is recommended (Grade C). For papillary breast lesions with atypia, complete surgical excision is recommended (Grade C).
authors.affiliation: Department of Gynecology, Rennes University Hospital, France; ER440, Oncogenesis, Stress and Signaling, INSERM Labeled, CRLCC Eugène Marquis, Rennes, France; University of Rennes 1, France. Electronic address: cngof@club-internet.fr.
authors.forename: Vincent
authors.initials: V
authors.lastname: Lavoué
authors.affiliation: University of Poitiers, CIC 1402, Poitiers University Hospital, Poitiers, France; CESP Inserm U1018, Kremlin-Bicêtre, France.
authors.forename: Xavier
authors.initials: X
authors.lastname: Fritel
authors.affiliation: Department of Anatomical Pathology, Hôpital Tenon, 4 rue de la Chine, 75020 Paris, France.
authors.forename: Martine
authors.initials: M
authors.lastname: Antoine
authors.affiliation: Department of Anatomical Pathology, Centre Régional de Lutte contre le cancer Georges-François Leclerc, Dijon, France.
authors.forename: Françoise
authors.initials: F
authors.lastname: Beltjens
authors.affiliation: Department of Gynecology, Obstetrics and Reproductive Medicine, Hôpital Tenon, AP-HP, INSERM UMRS707, 4 rue de la Chine, 75020 Paris, France.
authors.forename: Sofiane
authors.initials: S
authors.lastname: Bendifallah
authors.affiliation: Department of Radiology, Centre Régional de Lutte Contre le Cancer Bergognié, Bordeaux, France.
authors.forename: Martine
authors.initials: M
authors.lastname: Boisserie-Lacroix
authors.affiliation: Department of Gynecology and Obstetrics, Hôpital Jeanne de Flandre, Lille, France.
authors.forename: Loic
authors.initials: L
authors.lastname: Boulanger
authors.affiliation: Department of Gynecology, Obstetrics and Reproductive Medicine, Hôpital Tenon, AP-HP, Inserm UMRS938, 4 rue de la Chine, 75020 Paris, France.
authors.forename: Geoffroy
authors.initials: G
authors.lastname: Canlorbe
authors.affiliation: Department of Endocrine Gynecology, Hopital Jeanne de Flandre, Lille, France.
authors.forename: Sophie
authors.initials: S
authors.lastname: Catteau-Jonard
authors.affiliation: Department of Gynecology, Obstetrics and Reproductive Medicine, Hôpital Tenon, AP-HP, 4 rue de la Chine, 75020 Paris, France.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Chabbert-Buffet
authors.affiliation: Department of Radiology, Hôpital Européen Georges Pompidou, AP-HP, 15 rue Leblanc, 75015 Paris, France.
authors.forename: Foucauld
authors.initials: F
authors.lastname: Chamming's
authors.affiliation: Department of Surgery, Centre régional de lutte contre le cancer Paoli Calmettes, Marseille, France.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Chéreau
authors.affiliation: Department of Radiology, Hôpital Tenon, AP-HP, 4 rue de la Chine, 75020 Paris, France.
authors.forename: Jocelyne
authors.initials: J
authors.lastname: Chopier
authors.affiliation: Department of Surgery, Centre Régional de Lutte contre le cancer Georges-François Leclerc, Dijon, France.
authors.forename: Charles
authors.initials: C
authors.lastname: Coutant
authors.affiliation: Department of Gynecology and Obstetrics, Hôpital Jeanne de Flandre, Lille, France.
authors.forename: Julie
authors.initials: J
authors.lastname: Demetz
authors.affiliation: Department of Gynecology and Obstetrics, Poitiers University Hospital, 2 rue de la Milétrie, BP 577, 86021 Poitiers Cedex, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Guilhen
authors.affiliation: Department of Gynecology and Obstetrics, Caen University Hospital, Avenue de la Côte de Nacre, 14 033 Caen Cedex 09, France; University of Caen Normandy, INSERM U1199, BIOTICLA, France.
authors.forename: Raffaele
authors.initials: R
authors.lastname: Fauvet
authors.affiliation: Department of Anatomical Pathology, Hopital Jeanne de Flandre, Lille, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Kerdraon
authors.affiliation: Department of Gynecology, Obstetrics and Reproductive Medicine, Hôpital Tenon, AP-HP, 4 rue de la Chine, 75020 Paris, France.
authors.forename: Enora
authors.initials: E
authors.lastname: Laas
authors.affiliation: Department of Gynecology and Obstetrics, Angers University Hospital, France; CESP INSERM U1018, France.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Legendre
authors.affiliation: Mastology Unit, CHRU Strasbourg, Hôpital de Hautepierre, Avenue Molière, 67200 Strasbourg, France.
authors.forename: Carole
authors.initials: C
authors.lastname: Mathelin
authors.affiliation: Department of Gynecology and Obstetrics, Poitiers University Hospital, 2 rue de la Milétrie, BP 577, 86021 Poitiers Cedex, France.
authors.forename: Cédric
authors.initials: C
authors.lastname: Nadeau
authors.affiliation: Department of Radiology, Hôpital Tenon, AP-HP, 4 rue de la Chine, 75020 Paris, France.
authors.forename: Isabelle Thomassin
authors.initials: IT
authors.lastname: Naggara
authors.affiliation: Department of Oncological, Gynecological and Breast Surgery, Hôpital Européen Georges Pompidou, AP-HP, 15 rue Leblanc, 75015 Paris, France; Paris-Descartes University, Paris, France.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Ngô
authors.affiliation: Department of Gynecology, Tours University Hospital, Hôpital Bretonneau, 2 boulevard Tonnellé, 37044 Tours, France; Faculty of Medicine François-Rabelais, 37044 Tours, France; Unité INSERM 1069, 37044 Tours, France.
authors.forename: Lobna
authors.initials: L
authors.lastname: Ouldamer
authors.affiliation: Department of Obstetric Gynecology, Montpellier University Hospital, France.
authors.forename: Arash
authors.initials: A
authors.lastname: Rafii
authors.affiliation: Department of Radiology, Hôpital Hautepierre, 1 av Molière, 67100 Strasbourg, France.
authors.forename: Marie-Noelle
authors.initials: MN
authors.lastname: Roedlich
authors.affiliation: Medical Practice, 146 Avenue Ledru Rollin, 75011 Paris, France; Ultrasound Department, AP-HP, Hôpital Tenon, 4 rue de la Chine, 75020 Paris, France.
authors.forename: Jérémy
authors.initials: J
authors.lastname: Seror
authors.affiliation: Imagerie Duroc, R Boulevard du Montparnasse, 75006 Paris, France.
authors.forename: Jean-Yves
authors.initials: JY
authors.lastname: Séror
authors.affiliation: Department of Gynecology and Obstetrics, CHI, 40 avenue de Verdun, 94000 Créteil, France.
authors.forename: Cyril
authors.initials: C
authors.lastname: Touboul
authors.affiliation: Department of Gynecological and Breast Surgery and Oncology, AP-HP, Pitié-Salpêtrière, 83 Bd de l'Hôpital, 75013 Paris, France; Pierre et Marie Curie University, Paris 6, France.
authors.forename: Catherine
authors.initials: C
authors.lastname: Uzan
authors.affiliation: Department of Gynecology, Obstetrics and Reproductive Medicine, Hôpital Tenon, AP-HP, Inserm UMRS938, 4 rue de la Chine, 75020 Paris, France.
authors.forename: Emile
authors.initials: E
authors.lastname: Daraï
mesh_terms: D001706:Biopsy; D047688:Breast Cyst / Q000175:diagnosis / Q000628:therapy; D001941:Breast Diseases / Q000175:diagnosis; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000601:surgery / Q000628:therapy*; D002114:Calcinosis / Q000175:diagnosis / Q000473:pathology; D005260:Female; D005602:France; D006801:Humans; D006965:Hyperplasia / Q000473:pathology / Q000601:surgery; D008327:Mammography; D008413:Mastitis / Q000628:therapy; D059373:Mastodynia / Q000628:therapy; D000071936:Nipple Discharge / Q000000981:diagnostic imaging; D003557:Phyllodes Tumor / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D016217:Ultrasonography, Mammary
keywords: BI-RADS classification; Benign breast tumor; Mammogram; Pathological examination; Ultrasound