Breast surgeon role in the management of high-risk breast lesions

• Published in: Bulletin du cancer Vol. 101; no. 7-8; p. 718
• Main Authors: Colombo, Pierre-Emmanuel, Vincent-Salomon, Anne, Chateau, Marie-Christine, Mourregot, Anne, Gutowski, Marian, Laffargue, Guillaume, Masson, Bruno, Maran-Gonzalez, Aurélie, Rouanet, Philippe
• Format: Journal Article
• Language: French
• Published: France 01.07.2014
• Subjects: Age Factors; Biopsy; Breast - pathology; Breast Neoplasms - pathology; Breast Neoplasms - surgery; Calcinosis - diagnostic imaging; Carcinoma in Situ - pathology; Carcinoma in Situ - surgery; Carcinoma, Lobular - pathology; Carcinoma, Lobular - surgery; Cicatrix - etiology; Cicatrix - pathology; Epithelial Cells - pathology; Female; Humans; Hyperplasia - diagnostic imaging; Hyperplasia - pathology; Metaplasia - pathology; Papilloma, Intraductal - pathology; Papilloma, Intraductal - surgery; Population Surveillance; Precancerous Conditions - pathology; Precancerous Conditions - surgery; Radiation Injuries - etiology; Radiation Injuries - pathology; Radiation Injuries - surgery; Radiography; Risk; radial scar; papillary breast lesions; high-risk breast lesions; lobular neoplasia; atypical ductal hyperplasia; flat epithelial atypia
• ISSN: 1769-6917
• DOI: 10.1684/bdc.2014.2010

Diagnostics of high-risk breast lesions have increased these last years with the augmentation of breast percutaneous biopsies. They are lesions that confer an enlarged risk of breast cancer, either because of an increased probability of finding cancer after open surgery, a possible evolution toward in situ or invasive cancer, or because of an increased probability of developing breast cancer over the long term. Much progress has been made these last years in their histological diagnostic, classification and pathogenesis. Nevertheless, no consensus exists to date on the management of these "high-risk" lesions. In particular, surgical indications and follow-up modalities remain controversial for each histological type. In this review, the principal factors that could impact surgical decision and long-term follow-up are discussed with areas of controversy highlighted.