[ Les lesions mammaires dites "Border-Line": Prise en charge diagnostic et thérapeutique ]
Volume 7, Issue 2, August 2014, Pages 736–747
Ikram Lazrak1, Abdellah Babahabib2, Jaouad Kouach3, Driss Moussaoui4, and Mohammed Dehayni5
1 Service de Gynécologie Obstétrique, Hôpital Militaire Mohamed V RABAT, Morocco
2 Service gynécologie-obstétrique, Hôpital Militaire d’Instruction Mohamed V, Rabat, Morocco
3 Faculté de Médecine et de Pharmacie, Université Mohamed V, Rabat, Morocco
4 Department of Gynecology-Obstetric, Military Training Hospital Med V, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco
5 Department of Gynecology-Obstetric, Military Training Hospital Med V, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco
Original language: French
Copyright © 2014 ISSR Journals. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
As a consequence of breast imaging development and development of screening, benign epithelial breast diseases (BEBD) represent a growing percentage of breast pathology diagnoses. Some BEBD have to be individualized (radial scars, papillomas, complex sclerosing adenosis, lobular intraepithelial neoplasia, flat epithelial atypia, atypical hyperplasia), being preinvasive lesions or markers of increased breast cancer risk, or being associated with suspect radiological aspect. BEBD should be managed in a pluridisciplinar way and correctly diagnosed by percutaneous biopsies or surgical specimens. The goals of surgery vary according to lesions. It always allows a complete surgical specimen analysis and therefore a search for atypical or cancerous cells. Surgery can also have a preventive role by reducing the risk of potential malignant transformation. Finally, it enables in some cases the excision of a radiologically suspect mass. So the aim of this review is to give a clinical and morphological description of most common BEBD, underlying their cancer risk, specific diagnosis, therapeutic, follow-up and psychological repercussions.
Author Keywords: Concept of risk, screening, breast imaging, surgery, surveillance.
Volume 7, Issue 2, August 2014, Pages 736–747
Ikram Lazrak1, Abdellah Babahabib2, Jaouad Kouach3, Driss Moussaoui4, and Mohammed Dehayni5
1 Service de Gynécologie Obstétrique, Hôpital Militaire Mohamed V RABAT, Morocco
2 Service gynécologie-obstétrique, Hôpital Militaire d’Instruction Mohamed V, Rabat, Morocco
3 Faculté de Médecine et de Pharmacie, Université Mohamed V, Rabat, Morocco
4 Department of Gynecology-Obstetric, Military Training Hospital Med V, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco
5 Department of Gynecology-Obstetric, Military Training Hospital Med V, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco
Original language: French
Copyright © 2014 ISSR Journals. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
As a consequence of breast imaging development and development of screening, benign epithelial breast diseases (BEBD) represent a growing percentage of breast pathology diagnoses. Some BEBD have to be individualized (radial scars, papillomas, complex sclerosing adenosis, lobular intraepithelial neoplasia, flat epithelial atypia, atypical hyperplasia), being preinvasive lesions or markers of increased breast cancer risk, or being associated with suspect radiological aspect. BEBD should be managed in a pluridisciplinar way and correctly diagnosed by percutaneous biopsies or surgical specimens. The goals of surgery vary according to lesions. It always allows a complete surgical specimen analysis and therefore a search for atypical or cancerous cells. Surgery can also have a preventive role by reducing the risk of potential malignant transformation. Finally, it enables in some cases the excision of a radiologically suspect mass. So the aim of this review is to give a clinical and morphological description of most common BEBD, underlying their cancer risk, specific diagnosis, therapeutic, follow-up and psychological repercussions.
Author Keywords: Concept of risk, screening, breast imaging, surgery, surveillance.
Abstract: (french)
L'extension du dépistage organisé et le développement de l'imagerie mammaire font découvrir des lésions épithéliales bénignes à risque de plus en plus nombreuses. Certaines de ces lésions bénignes dites à risque minime relèvent d'une prise en charge (chirurgie et/ou surveillance), soit parce qu'elles entraînent des répercussions fonctionnelles gênantes, ou parce qu'elles s'accompagnent d'un risque accru de cancérisation, soit enfin parce que leur image radiologique est difficile à surveiller. Ces lésions mammaires se caractérisent par leur grande diversité (cicatrice radiaire, adénose sclérosante complexe, papillomes périphériques), certaines étant isolées ou associées à des lésions frontiéres à risque carcinologique (néoplasie lobulaire intraépithéliale, métaplasie cylindrique atypique, hyperplasie canalaire atypique). Elles doivent bénéficier d'une prise en charge optimale dans un contexte multidisciplinaire reposant sur des procédures d'analyse rigoureuses, tant au niveau des biopsies percutanées que des pièces opératoires.
Les buts de la chirurgie varient selon le type lésionnel. Elle permet toujours un bilan morphologique complet à la recherche d'éventuels foyers atypiques dispersés, voire carcinomateux. Elle peut avoir un rôle préventif en réduisant le risque d'une potentielle cancérisation ultérieure. Enfin, dans d'autres cas, elle permet simplement l'exérèse d'une image radiologique difficile à surveiller.
Le but de ce travail est de présenter les principales lésions mammaires épithéliales à risque qui sont diagnostiquées lors des bilans d'imagerie systématiques, soulignant à chaque fois leur prise en charge diagnostique, thérapeutique, psychologique et les modalités de leur surveillance.
Author Keywords: Notion de risque, dépistage, imagerie du sein, chirurgie, surveillance.
How to Cite this Article
Ikram Lazrak, Abdellah Babahabib, Jaouad Kouach, Driss Moussaoui, and Mohammed Dehayni, “Breast lesions called "Border-Line": Diagnosis, treatment and cancer risk,” International Journal of Innovation and Applied Studies, vol. 7, no. 2, pp. 736–747, August 2014.
