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Lavoue V, Favier A, Franck S, Boutet G, Azuar AS, Brousse S, Golfier F, Uzan C, Vaysse C, Molière S, Boisserie-Lacroix M, Kermarrec E, Seror JY, Delpech Y, Luporsi É, Maugard CM, Taris N, Chabbert-Buffet N, Sabah J, Alghamdi K, Fritel X, Mathelin C. French college of gynecologists and obstetricians (CNGOF) recommendations for clinical practice: Place of breast self-examination in screening strategies. Breast 2024; 75:103619. [PMID: 38547580 PMCID: PMC10990735 DOI: 10.1016/j.breast.2023.103619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 11/26/2023] [Accepted: 11/29/2023] [Indexed: 04/07/2024] Open
Abstract
Breast cancer is the most common female cancer in the world. Numerous studies have shown that the risk of metastatic disease increases with tumor volume. In this context, it is useful to assess whether the regular practice of formal breast self-examination (BSE) as opposed to breast awareness has an impact on the number of cancers diagnosed, their stage, the treatments used and mortality. DESIGN The Commission of Senology (CS) of the Collège National de Gynécologie et Obstétrique Français (CNGOF) respected and followed the Grading of Recommendations Assessment, Development and Evaluation method to assess the quality of the evidence on which the recommendations were based. METHODS The CS studied 16 questions individualizing four groups of women (general population, women aged over 75, high-risk women, and women previously treated for breast cancer). For each situation, it was determined whether the practice of BSE versus abstention from this examination led to detection of more breast cancers and/or recurrences and/or reduced treatment and/or increased survival. RESULTS BSE should not be recommended for women in the general population, who otherwise benefit from clinical breast examination by practitioners from the age of 25, and from organized screening from 50 to 74 (strong recommendation). In the absence of data on the benefits of BSE in patients aged over 75, for those at high risk and those previously treated for breast cancer, the CS was unable to issue recommendations. Thus, if women in these categories wish to undergo BSE, information on the benefits and risks observed in the general population must be given, notably that BSE is associated with a higher number of referrals, biopsies, and a reduced quality of life.
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Affiliation(s)
- Vincent Lavoue
- CHU Service de Gynécologie, 16 Boulevard de Bulgarie, 35200, Rennes, France
| | - Amélia Favier
- Gynécologie-obstétrique et Médecine de La Reproduction, Maternité Hôpital Tenon, 4 Rue de La Chine, 75020, Paris, France
| | - Sophie Franck
- Institut Curie, 26 Rue D'Ulm, 75248, Paris Cedex 05, France
| | - Gérard Boutet
- AGREGA, Service de Chirurgie Gynécologique et Médecine de La Reproduction, Centre Aliénor D'Aquitaine, Centre Hospitalier Universitaire de Bordeaux, Groupe Hospitalier Pellegrin, Place Amélie-Raba-Léon, 33000, Bordeaux, France
| | - Anne-Sophie Azuar
- Centre Hospitalier Clavary, Chemin de Clavary, 06130, Grasse, France
| | - Susie Brousse
- Service D'oncologie Chirurgicale, Centre Eugène Marquis, Unicancer, Rennes, France
| | - François Golfier
- Service de Chirurgie Gynécologique et Cancérologique - Obstétrique, Hospices Civils de Lyon, CHU Lyon Sud, Lyon, France
| | - Catherine Uzan
- Hôpital Pitié Salpetrière, 47 Bld de L'Hôpital, 75013, Paris, France
| | - Charlotte Vaysse
- Service de Chirurgie Oncologique, CHU Toulouse, Institut Universitaire Du Cancer de Toulouse-Oncopole, 1 Avenue Irène Joliot Curie, 31059, Toulouse, France
| | | | | | - Edith Kermarrec
- Hôpital Tenon Service de Radiologie, 4 Rue de La Chine, 75020, Paris, France
| | - Jean-Yves Seror
- Imagerie Duroc, 9 Ter Boulevard Montparnasse 75006 Paris, France
| | - Yann Delpech
- Centre Antoine Lacassagne, 33 Avenue de Valombrose, 06189, Nice, France
| | - Élisabeth Luporsi
- Oncologie Médicale et Oncogénétique, CHR Metz-Thionville, Hôpital de Mercy, 1 Allée Du Château, 57085, Metz, France
| | - Christine M Maugard
- Service de Génétique Oncologique Clinique et Unité de Génétique Oncologique Moléculaire, Hôpitaux Universitaires de Strasbourg, 1 Avenue Molière, 67200, Strasbourg, France
| | - Nicolas Taris
- Service de Génétique Oncologique, ICANS, 17 Rue Calmette, 67200, Strasbourg, France, France
| | | | - Jonathan Sabah
- CHRU Avenue Molière, 67200, Strasbourg et ICANS, 17 Rue Albert Calmette, 67033, Strasbourg,Cedex, France
| | - Khalid Alghamdi
- CHRU Avenue Molière, 67200, Strasbourg et ICANS, 17 Rue Albert Calmette, 67033, Strasbourg,Cedex, France
| | - Xavier Fritel
- Centre Hospitalo-universitaire de Poitiers, 2 Rue de La Milétrie, 86021, Poitiers, France
| | - Carole Mathelin
- CHRU Avenue Molière, 67200, Strasbourg et ICANS, 17 Rue Albert Calmette, 67033, Strasbourg,Cedex, France.
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Lavoué V, Favier A, Frank S, Boutet G, Azuar AS, Brousse S, Golfier F, Uzan C, Vaysse C, Molière S, Boisserie-Lacroix M, Kermarrec E, Seror JY, Delpech Y, Luporsi É, Maugard CM, Taris N, Chabbert-Buffet N, Sabah J, Alghamdi K, Fritel X, Mathelin C. [Place of breast self-examination in screening strategies. French College of Gynecologists and Obstetricians (CNGOF) recommendations for clinical practice]. Gynecol Obstet Fertil Senol 2023; 51:437-447. [PMID: 37652173 DOI: 10.1016/j.gofs.2023.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 08/24/2023] [Indexed: 09/01/2023]
Abstract
OBJECTIVES Breast cancer is the most common female cancer in the world. In France, over 60,000 new cases are currently diagnosed, and 12,000 deaths are attributed to it annually. Numerous studies have shown that the risk of metastatic disease increases with tumor volume. In this context, it is useful to assess whether the regular practice of breast self-examination (BSE) has an impact on the number of cancers diagnosed, their stage, the treatments used and mortality. DESIGN the CNGOF's Commission de Sénologie (CS), composed by 17 experts and 3 invited members, drew up these recommendations. No funding was provided for the development of these recommendations. The CS respected and followed the GRADE (Grading of Recommendations Assessment, Development and Evaluation) method to assess the quality of the evidence on which the recommendations were based. METHODS The CS studied 16 questions concerning BSE, individualizing four groups of women (general population, women aged over 75, high-risk women, and women previously treated for breast cancer). For each situation, it was determined whether the practice of BSE compared with abstention from this examination led to the detection of more breast cancers and/or recurrences and/or reduced treatment and/or increased survival. RESULTS BSE should not be recommended for women in the general population, who otherwise benefit from a clinical breast examination (by the attending physician or gynecologist) from the age of 25, and from organized screening from 50 to 74 (strong recommendation). However, in the absence of data on the role of BSE in patients aged over 75, those at high risk of breast cancer and those previously treated for breast cancer, the CS was unable to issue recommendations. Thus, if women in these latter categories wish to undergo BSE, they must be given rigorous training in the technique, and information on the benefits and risks observed in the general population. Finally, the CS invites all women who detect a change or abnormality in their breasts to consult a healthcare professional without delay. CONCLUSION BSE is not recommended for women in the general population. No recommendation can be established for women aged over 75, those at high risk of breast cancer and those previously treated for breast cancer.
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Affiliation(s)
- Vincent Lavoué
- Service de gynécologie, CHU de Rennes, 16, boulevard de Bulgarie, 35200 Rennes, France
| | - Amélia Favier
- Gynécologie-obstétrique et médecine de la reproduction - maternité, hôpital Tenon, 4, rue de la Chine, 75020 Paris, France
| | - Sophie Frank
- Institut Curie, 26, rue d'Ulm, 75248 Paris cedex 05, France
| | - Gérard Boutet
- AGREGA, service de chirurgie gynécologique et médecine de la reproduction, centre Aliénor d'Aquitaine, CHU de Bordeaux, groupe hospitalier Pellegrin, place Amélie-Raba-Léon, 33000 Bordeaux, France
| | | | - Susie Brousse
- Service d'oncologie chirurgicale, centre Eugène-Marquis, Unicancer, Rennes, France
| | - François Golfier
- Service de chirurgie gynécologique et cancérologique - obstétrique, hospices civils de Lyon, CHU Lyon Sud, Lyon, France
| | - Catherine Uzan
- Hôpital Pitié-Salpetrière, 47, boulevard de l'Hôpital, 75013 Paris, France
| | - Charlotte Vaysse
- Service de chirurgie oncologique, institut universitaire du cancer de Toulouse-Oncopole, CHU de Toulouse, 1, avenue Irène-Joliot-Curie, 31059 Toulouse, France
| | - Sébastien Molière
- Imagerie du sein, CHRU de Strasbourg, avenue Molière, 67200 Strasbourg, France
| | | | - Edith Kermarrec
- Service de radiologie, hôpital Tenon, 4, rue de la Chine, 75020 Paris, France
| | - Jean-Yves Seror
- Imagerie Duroc, 9 ter, boulevard Montparnasse, 75006 Paris, France
| | - Yann Delpech
- Centre Antoine-Lacassagne, 33, avenue de Valombrose, 06189 Nice, France
| | - Élisabeth Luporsi
- Oncologie médicale et oncogénétique, hôpital de Mercy, CHR Metz-Thionville, 1, allée du Château, 57085 Metz, France
| | - Christine M Maugard
- Service de génétique oncologique clinique, unité de génétique oncologique moléculaire, hôpitaux universitaires de Strasbourg, 1, avenue Molière, 67200 Strasbourg, France
| | - Nicolas Taris
- Service de génétique oncologique, ICANS, 17, rue Calmette, 67200 Strasbourg, France
| | | | - Jonathan Sabah
- CHRU de Strasbourg, avenue Molière, 67200 Strasbourg, France; ICANS, 17, rue Albert-Calmette, 67033 Strasbourg cedex, France
| | - Khalid Alghamdi
- CHRU de Strasbourg, avenue Molière, 67200 Strasbourg, France; ICANS, 17, rue Albert-Calmette, 67033 Strasbourg cedex, France
| | - Xavier Fritel
- Centre hospitalo-universitaire de Poitiers, 2, rue de la Milétrie, 86021 Poitiers, France
| | - Carole Mathelin
- CHRU de Strasbourg, avenue Molière, 67200 Strasbourg, France; ICANS, 17, rue Albert-Calmette, 67033 Strasbourg cedex, France.
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Molière S, Boutet G, Azuar AS, Boisserie-Lacroix M, Brousse S, Golfier F, Kermarrec É, Lavoué V, Seror JY, Uzan C, Vaysse C, Lodi M, Mathelin C. [Lipofilling in the management of breast cancer: An update based on a literature review and national and international guidelines]. Gynecol Obstet Fertil Senol 2023; 51:471-480. [PMID: 37419415 DOI: 10.1016/j.gofs.2023.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Accepted: 07/01/2023] [Indexed: 07/09/2023]
Abstract
BACKGROUND Lipomodelling (LM) is an increasingly used technique to reconstruct or correct an aesthetic defect linked to a loss of substance. In France, the Haute Autorité de santé (HAS) published recommendations in 2015 and 2020 concerning the conditions of use of LM on the treated and contralateral breast. These appear to be inconsistently followed. METHODS Twelve members of the Senology Commission of the Collège national des gynécologues-obstétriciens français (French College of Gynecologists and Obstetricians) reviewed the carcinological safety of LM and the clinical and radiological follow-up of patients after breast cancer surgery, based on French and international recommendations and a review of the literature. The bibliographic search was conducted via Medline from 2015 to 2022, selecting articles in French and English and applying PRISMA guidelines. RESULTS A total of 14 studies on the oncological safety of LM, 5 studies on follow-up and 7 guidelines were retained. The 14 studies (6 retrospective, 2 prospective and 6 meta-analyses) had heterogeneous inclusion criteria and variable follow-up, ranging from 38 to 120 months. Most have shown no increased risk of locoregional or distant recurrence after LM. A retrospective case-control study (464 LMs and 3100 controls) showed, in patients who had no recurrence at 80 months, a subsequent reduction in recurrence-free survival after LM in cases of luminal A cancer, highlighting the number of lost to follow-up (more than 2/3 of luminal A cancers). About follow-up after LM, the 5 series showed the high frequency after LM of clinical mass and radiological images (in ¼ of cases), most often corresponding to cytosteatonecrosis. Most of the guidelines highlighted the uncertainties concerning oncological safety of LM, due to the lack of prospective data and long-term follow-up. DISCUSSION AND PERSPECTIVES The members of the Senology Commission agree with the conclusions of the HAS working group, in particular by advising against LM "without cautionary periods", excessively, or in cases of high risk of relapse, and recommend clear, detailed information to patients before undergoing LM, and the need for postoperative follow-up. The creation of a national registry could address most questions regarding both the oncological safety of this procedure and the modalities of patient follow-up.
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Affiliation(s)
- S Molière
- Imagerie du Sein, CHRU, avenue Molière, 67200 Strasbourg, France.
| | - G Boutet
- AGREGA, service de chirurgie gynécologique et médecine de la reproduction, centre Aliénor d'Aquitaine, CHU de Bordeaux, groupe hospitalier Pellegrin, place Amélie-Raba-Léon, 33000 Bordeaux, France.
| | - A-S Azuar
- Centre hospilalier Clavary, chemin de Clavary, 06130 Grasse, France.
| | - M Boisserie-Lacroix
- Unité de radiologie-sénologie, institut Bergonié, 229, cours de l'Argonne, 33000 Bordeaux, France.
| | - S Brousse
- Service d'oncologie chirurgicale, centre Eugène-Marquis, Unicancer, Rennes, France.
| | - F Golfier
- Service de chirurgie gynécologique et cancérologique - obstétrique, hospices civils de Lyon, CHU de Lyon Sud, Lyon, France.
| | - É Kermarrec
- Service de radiologie, hôpital Tenon, 4, rue de la Chine, 75020 Paris, France.
| | - V Lavoué
- Service de gynécologie, CHU, 16, boulevard de Bulgarie, 35200 Rennes, France.
| | - J-Y Seror
- 9, terrasse boulevard Montparnasse, 75006 Paris, France.
| | - C Uzan
- Hôpital Pitié-Salpetrière, 47, boulevard de l'Hôpital, 75013 Paris, France.
| | - C Vaysse
- Service de chirurgie oncologique, institut universitaire du cancer de Toulouse-Oncopole, CHU de Toulouse, 1, avenue Irène-Joliot-Curie, 31059 Toulouse, France.
| | - M Lodi
- CHRU, avenue Molière, 67200 Strasbourg, France.
| | - C Mathelin
- CHRU, avenue Molière, 67200 Strasbourg, France; ICANS, 17, rue Albert-Calmette, 67033 Strasbourg cedex, France.
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Boisserie-Lacroix M, Espié N. « Préannonce » et annonce du cancer par le radiologue : recommandations et pratique. Imagerie de la Femme 2023. [DOI: 10.1016/j.femme.2023.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023]
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Linck PA, Boisserie-Lacroix M, Deleau F, Brocard C, Gaillard AL, Manse L, Raykova M, Depetiteville MP, Chamming's F. Images subtiles en mammographie et échographie (non-masses). Imagerie de la Femme 2023. [DOI: 10.1016/j.femme.2023.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023]
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Chamming's F, Depetiteville MP, Linck PA, Gaillard AL, Deleau F, Brocard C, Boisserie-Lacroix M. Cancers du sein « ACR 3 ». Imagerie de la Femme 2022. [DOI: 10.1016/j.femme.2022.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Mathelin C, Barranger E, Boisserie-Lacroix M, Boutet G, Brousse S, Chabbert-Buffet N, Coutant C, Daraï E, Delpech Y, Duraes M, Espié M, Fornecker L, Golfier F, Grosclaude P, Hamy AS, Kermarrec E, Lavoué V, Lodi M, Luporsi É, Maugard CM, Molière S, Seror JY, Taris N, Uzan C, Vaysse C, Fritel X. [Non-genetic indications for risk reducing mastectomies: Guidelines of the National College of French Gynecologists and Obstetricians (CNGOF)]. Gynécologie Obstétrique Fertilité & Sénologie 2022; 50:107-120. [PMID: 34920167 DOI: 10.1016/j.gofs.2021.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
OBJECTIVE To determine the value of performing a risk-reducting mastectomy (RRM) in the absence of a deleterious variant of a breast cancer susceptibility gene, in 4 clinical situations at risk of breast cancer. DESIGN The CNGOF Commission of Senology, composed of 26 experts, developed these recommendations. A policy of declaration and monitoring of links of interest was applied throughout the process of making the recommendations. Similarly, the development of these recommendations did not benefit from any funding from a company marketing a health product. The Commission of Senology adhered to the AGREE II (Advancing guideline development, reporting and evaluation in healthcare) criteria and followed the Grading of Recommendations Assessment, Development and Evaluation (GRADE) method to assess the quality of the evidence on which the recommendations were based. The potential drawbacks of making recommendations in the presence of poor quality or insufficient evidence were highlighted. METHODS The Commission of Senology considered 8 questions on 4 topics, focusing on histological, familial (no identified genetic abnormality), radiological (of unrecognized cancer), and radiation (history of Hodgkin's disease) risk. For each situation, it was determined whether performing RRM compared with surveillance would decrease the risk of developing breast cancer and/or increase survival. RESULTS The Commission of Senology synthesis and application of the GRADE method resulted in 11 recommendations, 6 with a high level of evidence (GRADE 1±) and 5 with a low level of evidence (GRADE 2±). CONCLUSION There was significant agreement among the Commission of Senology members on recommendations to improve practice for performing or not performing RRM in the clinical setting.
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Affiliation(s)
- Carole Mathelin
- CHRU, avenue Molière, 67200 Strasbourg, France; ICANS, 17, rue Albert-Calmette, 67033 Strasbourg cedex, France.
| | | | | | - Gérard Boutet
- AGREGA, service de chirurgie gynécologique et médecine de la reproduction, centre Aliénor d'Aquitaine, centre hospitalier universitaire de Bordeaux, groupe hospitalier Pellegrin, place Amélie-Raba-Léon, 33000 Bordeaux, France.
| | - Susie Brousse
- CHU de Rennes, 2, rue Henri-le-Guilloux, 35033 Rennes cedex 9, France.
| | | | - Charles Coutant
- Département d'oncologie chirurgicale, centre Georges-François-Leclerc, 1, rue du Pr-Marion, 21079 Dijon cedex, France.
| | - Emile Daraï
- Hôpital Tenon, service de gynécologie-obstétrique, 4, rue de la Chine, 75020 Paris, France.
| | - Yann Delpech
- Centre Antoine-Lacassagne, 33, avenue de Valombrose, 06189 Nice, France.
| | - Martha Duraes
- CHU de Montpellier, 191, avenue du Doyen-Giraud, 34295 Montpellier cedex, France.
| | - Marc Espié
- Hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France.
| | - Luc Fornecker
- Département d'onco-hématologie, ICANS, 17, rue Albert-Calmette, 67033 Strasbourg cedex, France.
| | - François Golfier
- Centre hospitalier Lyon Sud, bâtiment 3B, 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite, France.
| | | | | | - Edith Kermarrec
- Hôpital Tenon, service de radiologie, 4, rue de la Chine, 75020 Paris, France.
| | - Vincent Lavoué
- CHU, service de gynécologie, 16, boulevard de Bulgarie, 35200 Rennes, France.
| | | | - Élisabeth Luporsi
- Oncologie médicale et oncogénétique, CHR Metz-Thionville, hôpital de Mercy, 1, allée du Château, 57085 Metz, France.
| | - Christine M Maugard
- Service de génétique oncologique clinique, unité de génétique oncologique moléculaire, hôpitaux universitaires de Strasbourg, 1, avenue Molière, 67200 Strasbourg, France.
| | | | | | - Nicolas Taris
- Oncogénétique, ICANS, 17, rue Albert-Calmette, 67033 Strasbourg, France.
| | - Catherine Uzan
- Hôpital Pitié-Salpetrière, 47, boulevard de l'Hôpital, 75013 Paris, France.
| | - Charlotte Vaysse
- Service de chirurgie oncologique, CHU Toulouse, institut universitaire du cancer de Toulouse-Oncopole, 1, avenue Irène-Joliot-Curie, 31059 Toulouse, France.
| | - Xavier Fritel
- Centre hospitalo-universitaire de Poitiers, 2, rue de la Milétrie, 86021 Poitiers, France.
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Mathelin C, Barranger E, Boisserie-Lacroix M, Boutet G, Brousse S, Chabbert-Buffet N, Coutant C, Daraï E, Delpech Y, Duraes M, Espié M, Golfier F, Hamy AS, Kermarrec E, Lavoué V, Lodi M, Luporsi É, Maugard C, Molière S, Seror JY, Taris N, Uzan C, Vaysse C, Fritel X. [Techniques and complications of non-genetic risk reducing mastectomies: Guidelines of the National College of French Gynecologists and Obstetricians (CNGOF)]. Gynecol Obstet Fertil Senol 2022; 50:121-129. [PMID: 34922037 DOI: 10.1016/j.gofs.2021.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
OBJECTIVE Based on an updated review of the international literature covering the different surgical techniques and complications of risk reducing mastectomies (RRM) in non-genetic context, the Commission of Senology (CS) of the College National des Gynécologues Obstétriciens Français (CNGOF) aimed to establish recommendations on the techniques to be chosen and their implementation. DESIGN The CNGOF CS, composed of 24 experts, developed these recommendations. A policy of declaration and monitoring of links of interest was applied throughout the process of making the recommendations. Similarly, the development of these recommendations did not benefit from any funding from a company marketing a health product. The CS adhered to and followed the AGREE II (Advancing guideline development, reporting and evaluation in healthcare) criteria and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) method to assess the quality of the evidence on which the recommendations were based. The potential drawbacks of making recommendations in the presence of poor quality or insufficient evidence were highlighted. METHODS The CS considered 6 questions in 4 thematic areas, focusing on oncologic safety, risk of complications, aesthetic satisfaction and psychological impact, and preoperative modalities. RESULTS The application of the GRADE method resulted in 7 recommendations, 6 with a high level of evidence (GRADE 1±) and 1 with a low level of evidence (GRADE 2±). CONCLUSION There was significant agreement among the CS members on recommendations for preferred surgical techniques and practical implementation.
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Affiliation(s)
- C Mathelin
- CHRU, avenue Molière, 67200 Strasbourg, France; ICANS, 17, rue Albert-Calmette, 67033 Strasbourg cedex, France.
| | - E Barranger
- Centre Antoine-Lacassagne, 36, avenue de Valombrose, 06189 Nice, France
| | | | - G Boutet
- AGREGA, service de chirurgie gynécologique et médecine de la reproduction, centre Aliénor d'Aquitaine, centre hospitalier universitaire de Bordeaux, groupe hospitalier Pellegrin, place Amélie-Raba-Léon, 33 000 Bordeaux, France
| | - S Brousse
- CHU de Rennes, 2, rue Henri-le-Guilloux, 35033 Rennes cedex 9, France
| | | | - C Coutant
- Département d'oncologie chirurgicale, centre Georges-François-Leclerc, 1, rue du Pr Marion, 21079 Dijon cedex, France
| | - E Daraï
- Hôpital Tenon, 4, rue de la Chine, 75020 Paris, France
| | - Y Delpech
- Centre Antoine Lacassagne, 33, avenue de Valombrose, 06189 Nice, France
| | - M Duraes
- CHU de Montpellier, 191, avenue du Doyen-Giraud, 34295 Montpellier cedex, France
| | - M Espié
- Hôpital St Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France
| | - F Golfier
- Centre hospitalier Lyon Sud, bâtiment 3B, 165, chemin du Grand-Revoyet, 69495 Pierre Benite, France
| | - A S Hamy
- Institut Curie, 26, rue d'Ulm, 75248 Paris, France
| | - E Kermarrec
- Service de radiologie, hôpital Tenon, 4, rue de la Chine, 75020 Paris, France
| | - V Lavoué
- Service de gynécologie, CHU, 16, boulevard de Bulgarie, 35200 Rennes, France
| | - M Lodi
- CHU, avenue Molière, 67200 Strasbourg, France
| | - É Luporsi
- Oncologie médicale et oncogénétique, hôpital de Mercy, CHR Metz-Thionville, 1, allée du Château, 57085 Metz, France
| | - C Maugard
- Service de génétique oncologique clinique et unité de génétique oncologique moléculaire, hôpitaux universitaires de Strasbourg, 1, avenue Molière, 67200 Strasbourg
| | - S Molière
- Imagerie du sein, CHRU, avenue Molière 67200 Strasbourg, France
| | - J-Y Seror
- Cabinet privé, 9 ter boulevard Montparnasse, 75006 Paris, France
| | - N Taris
- Oncogénétique, ICANS, 17, rue Albert Calmette, 67033 Strasbourg, France
| | - C Uzan
- Hôpital Pitié-Salpetrière, 47, boulevard de l'Hôpital, 75013 Paris, France
| | - C Vaysse
- Service de chirurgie oncologique, CHU de Toulouse, institut universitaire du cancer de Toulouse-Oncopole, 1, avenue Irène-Joliot-Curie, 31059 Toulouse, France
| | - X Fritel
- Centre hospitalo-universitaire de Poitiers, 2, rue de la Milétrie, 86021 Poitiers, France
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Boisserie-Lacroix M, Linck PA, Deleau F, Gaillard AL, Brocard C, Depetiteville MP, Chamming's F. Asymétries mammographiques : prise en charge et apport de la tomosynthèse. Imagerie de la Femme 2022. [DOI: 10.1016/j.femme.2021.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Linck PA, Garnier C, Depetiteville MP, MacGrogan G, Mathoulin-Pélissier S, Quénel-Tueux N, Charitansky H, Boisserie-Lacroix M, Chamming's F. Impact of the COVID-19 lockdown in France on the diagnosis and staging of breast cancers in a tertiary cancer centre. Eur Radiol 2021; 32:1644-1651. [PMID: 34647179 PMCID: PMC8514205 DOI: 10.1007/s00330-021-08264-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 07/09/2021] [Accepted: 07/23/2021] [Indexed: 01/21/2023]
Abstract
Objectives Due to COVID-19, a lockdown took place between March 17 and May 1, 2020, in France. This study evaluates the impact of the lockdown on the diagnosis and staging of breast cancers in a tertiary cancer centre. Methods Our database was searched for all consecutive invasive breast cancers diagnosed in our institution during the lockdown (36 working days), during equivalent periods of 36 working days before and after lockdown and a reference period in 2019. The number and staging of breast cancers diagnosed during and after lockdown were compared to the pre-lockdown and reference periods. Tumour maximum diameters were compared using the Mann–Whitney test. Proportions of tumour size categories (T), ipsilateral axillary lymph node invasion (N) and presence of distant metastasis (M) were compared using Fisher’s exact test. Results Compared to the reference period (n = 40 in average), the number of breast cancers diagnosed during lockdown (n = 32) decreased by 20% but increased by 48% after the lockdown (n = 59). After the lockdown, comparatively to the reference period, breast cancers were more often symptomatic (86% vs 57%; p = 0.001) and demonstrated bigger tumour sizes (p = 0.0008), the rates of small tumours (T1) were reduced by 38%, locally advanced cancers (T3, T4) increased by 80% and lymph node invasion increased by 64%. Conclusion The COVID-19 lockdown was associated with a 20% decrease in the number of diagnosed breast cancers. Because of delayed diagnosis, breast cancers detected after the lockdown had poorer prognosis with bigger tumour sizes and higher rates of node invasion. Key Points • The number of breast cancer diagnosed in a large tertiary cancer centre in France decreased by 20% during the first COVID-19 lockdown. • Because of delayed diagnosis, breast cancers demonstrated bigger tumour size and more frequent axillary lymph node invasion after the lockdown. • In case of a new lockdown, breast screening programme and follow-up examinations should not be suspended and patients with clinical symptoms should be encouraged to seek attention promptly.
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Affiliation(s)
- Pierre-Antoine Linck
- Department of Radiology, Institut Bergonié, Comprehensive Cancer Centre, 33076, Bordeaux, France
| | - Cassandre Garnier
- Department of Radiology, Institut Bergonié, Comprehensive Cancer Centre, 33076, Bordeaux, France
| | | | - Gaëtan MacGrogan
- Department of Pathology, Institut Bergonié, Comprehensive Cancer Centre, 33076, Bordeaux, France
| | - Simone Mathoulin-Pélissier
- Unité D'Épidémiologie Et de Recherche Cliniques, Institut Bergonié, Comprehensive Cancer Centre, 33076, Bordeaux, France.,Inserm UMR 1219, Epicene Team, Bordeaux, France.,Inserm CIC-EC 1401, Bordeaux, France
| | - Nathalie Quénel-Tueux
- Department of Medical Oncology, Institut Bergonié, Comprehensive Cancer Centre, 33076, Bordeaux, France
| | - Hélène Charitansky
- Department of Surgery, Institut Bergonié, Comprehensive Cancer Centre, 33076, Bordeaux, France
| | | | - Foucauld Chamming's
- Department of Radiology, Institut Bergonié, Comprehensive Cancer Centre, 33076, Bordeaux, France.
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Boisserie-Lacroix M, Doutriaux-Dumoulin I, Chopier J, Boyer B, Depetiteville MP, Hoppe S, Brouste V, Chamming's F. Diagnostic accuracy of breast MRI for patients with suspicious nipple discharge and negative mammography and ultrasound: a prospective study. Eur Radiol 2021; 31:7783-7791. [PMID: 33846843 DOI: 10.1007/s00330-021-07790-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 01/15/2021] [Accepted: 02/15/2021] [Indexed: 01/03/2023]
Abstract
OBJECTIVES To evaluate the diagnostic accuracy of breast MRI in identifying lesions requiring excision for patients with suspicious nipple discharge but normal mammograms and ultrasounds. METHODS Between September 2013 and May 2019, 106 female participants (mean age 57.9 years) were consecutively included in this prospective multicenter study; 102 were retained for analysis. MRI was considered negative in the absence of suspicious enhancement and positive in cases of ipsilateral abnormal enhancement (BI-RADS 3 to 5). Final diagnoses were based on histological findings of surgical or percutaneous biopsies or at 1-year follow-up. We considered all lesions requiring excision found on pathology (papilloma, atypia, nipple adenomatosis, or cancer) as positive results. We considered spontaneous resolution of the discharge at 1 year as a negative result. RESULTS MRI showed ipsilateral abnormal enhancement in 54 patients (53%) revealing 46 lesions requiring excision (31 benign papillomas, 5 papillomas with atypia, 2 nipple adenomatosis, and 8 cancers) and 8 benign lesions not requiring excision. No suspicious enhancement was found in the remaining 48 participants (47%). Forty-two were followed up at 1 year with spontaneous resolution of the discharge and six underwent surgery (revealing 2 benign papillomas). MRI diagnostic accuracy for the detection of a lesion requiring excision was as follows: sensitivity 96%, specificity 85%, positive predictive value 85%, and negative predictive value 96%. CONCLUSION In patients with suspicious nipple discharge and normal mammogram and ultrasound, MRI demonstrates excellent performance to identify lesions for which excision is required. Normal MRI indicates it is safe to propose follow-up only management, thus avoiding unnecessary duct excision. TRIAL REGISTRATION ClinicalTrials.gov NCT02819362 KEY POINTS: • Breast MRI can be useful for the management of patients with suspicious nipple discharge and negative mammogram and ultrasound. • MRI detected a lesion requiring excision in 46 participants (45%) with unexplained discharge. • If breast MRI is negative, follow-up is a safe alternative for these patients.
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Affiliation(s)
| | - Isabelle Doutriaux-Dumoulin
- Department of Radiology, Institut de Cancérologie de l'Ouest, Comprehensive Cancer Centre, F-44000, Saint-Herblain, France
| | - Jocelyne Chopier
- Department of Radiology, Hôpital Tenon, Assistance Publique-Hôpitaux de Paris, F-75020, Paris, France
| | - Bruno Boyer
- Breast Imaging Clinic, 6 place d'Italie, F-75013, Paris, France
| | | | - Stéphanie Hoppe
- Clinical and Epidemiological Research Unit, Institut Bergonié, Comprehensive Cancer Centre, F-33076, Bordeaux, France
| | - Véronique Brouste
- Clinical and Epidemiological Research Unit, Institut Bergonié, Comprehensive Cancer Centre, F-33076, Bordeaux, France
| | - Foucauld Chamming's
- Department of Radiology, Institut Bergonié, Comprehensive Cancer Centre, F-33076, Bordeaux, France
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Boisserie-Lacroix M, Depetiteville MP, Catena V, Chamming's F. Écoulements mamelonnaires : nouveaux standards ? Imagerie de la Femme 2019. [DOI: 10.1016/j.femme.2019.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Boisserie-Lacroix M, Depetiteville MP, Chamming's F. Interprétation en échographie mammaire : images hyperéchogènes. Imagerie de la Femme 2019. [DOI: 10.1016/j.femme.2019.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Henrot P, Boisserie-Lacroix M, Boute V, Troufléau P, Boyer B, Lesanne G, Gillon V, Desandes E, Netter E, Saadate M, Tardivon A, Grentzinger C, Salleron J, Oldrini G. Self-compression Technique vs Standard Compression in Mammography: A Randomized Clinical Trial. JAMA Intern Med 2019; 179:407-414. [PMID: 30715083 PMCID: PMC6440229 DOI: 10.1001/jamainternmed.2018.7169] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Accepted: 10/01/2018] [Indexed: 11/14/2022]
Abstract
Importance Many women dread undergoing mammography, and some may not attend or reattend breast cancer screening because of the discomfort or pain induced by breast compression. Objective To evaluate the noninferiority of the self-compression mammography technique for reducing breast thickness compared with standard compression. Design, Setting, and Participants This prospective, parallel-group, noninferiority randomized clinical trial was conducted from May 7, 2013, to October 26, 2015, at 6 cancer care centers in France. Participants were women aged 50 to 75 years, without a history of recent breast surgical procedure or treatment, and who could perform self-compression. Analyses were performed on intention-to-treat basis from January 27, 2017, to March 30, 2018. Interventions Patients were randomized 1:1 to the self-compression group or the standard compression group. Main Outcomes and Measures Primary end point was breast thickness expressed as the mean of 4 views: right and left craniocaudal and right and left mediolateral oblique. The predefined noninferiority margin was a difference of 3 mm, with a 1-sided 95% CI. Secondary end points included compression force, image quality, requirement for additional views, pain, and patient satisfaction and radiographer assessment questionnaires. Results Among the 549 women randomized, 548 (97.3%) completed the trial. Of these, 275 (48.8%) (mean [SD] age, 61.35 [6.34] years) were randomized to the self-compression arm and 273 (48.5%) (mean [SD] age, 60.84 [6.41] years) to the standard compression arm. The difference in the mean thickness between the 2 arms was lower than the noninferiority margin, with an upper 1-sided 95% CI less than 3 mm (-0.17; 95% CI,-∞ to 1.89 mm; P < .05). Compression force was higher in the self-compression group compared with the standard compression arm for the 4 mammographic views. Pain was statistically significantly lower in the self-compression group (n = 274) compared with the standard compression group (n = 269) (median [interquartile range (IQR)] score, 2 [1-5] vs 3 [1-5]; P = .009). No difference was reported in the image quality scores of the 2 groups or in the number of additional views performed (median [IQR] extra views, 2 [2-2] vs 2 [2-3] extra views; P = .64), whatever the indication, including insufficient image quality (29 [16.8%] vs 27 [15.0%] insufficient quality views; P = .65). No adverse effects or pain were reported by the participants after the self-compression mammography. Conclusions and Relevance Self-compression does not appear to be inferior to standard compression mammography in achieving minimal breast thickness without increasing pain or compromising image quality; this technique may be an effective option for women who want to be involved in their breast examination. Trial Registration ClinicalTrials.gov identifier: NCT02866591.
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Affiliation(s)
- Philippe Henrot
- Department of Radiology, Institut de Cancérologie de Lorraine Alexis Vautrin, Vandœuvre-lès-Nancy, France
| | | | - Véronique Boute
- Department of Radiology, Centre François Baclesse, Caen, France
| | - Philippe Troufléau
- Department of Radiology, Institut de Cancérologie de Lorraine Alexis Vautrin, Vandœuvre-lès-Nancy, France
| | - Bruno Boyer
- Department of Radiology, Institut de Cancérologie de Lorraine Alexis Vautrin, Vandœuvre-lès-Nancy, France
| | - Grégory Lesanne
- Department of Radiology, Institut de Cancérologie de Lorraine Alexis Vautrin, Vandœuvre-lès-Nancy, France
| | - Véronique Gillon
- Department of Radiology, Institut de Cancérologie de Lorraine Alexis Vautrin, Vandœuvre-lès-Nancy, France
| | - Emmanuel Desandes
- Department of Radiology, Institut de Cancérologie de Lorraine Alexis Vautrin, Vandœuvre-lès-Nancy, France
| | | | | | - Anne Tardivon
- Department of Radiology, Institut Curie, Paris, France
| | | | - Julia Salleron
- Department of Radiology, Institut de Cancérologie de Lorraine Alexis Vautrin, Vandœuvre-lès-Nancy, France
| | - Guillaume Oldrini
- Department of Radiology, Institut de Cancérologie de Lorraine Alexis Vautrin, Vandœuvre-lès-Nancy, France
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Chamming's F, Bouaboula M, Depetiteville MP, Catena V, Rousseau C, Boisserie-Lacroix M. Cancers lobulaires infiltrants : imagerie conventionnelle et gestes interventionnels. Imagerie de la Femme 2017. [DOI: 10.1016/j.femme.2017.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Boisserie-Lacroix M, Lippa N, Ziadé C, Ferron S, Hurtevent-Labrot G. Masses : quel apport de la tomosynthèse ? Imagerie de la Femme 2016. [DOI: 10.1016/j.femme.2016.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Boisserie-Lacroix M, Ziadé C, Hurtevent-Labrot G, Ferron S, Depetiteville MP. Microcalcifications : quel apport de la tomosynthèse ? Imagerie de la Femme 2016. [DOI: 10.1016/j.femme.2016.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Boisserie-Lacroix M, Ziadé C, Hurtevent-Labrot G, Ferron S, Brouste V, Lippa N. Is a one-year follow-up an efficient method for better management of MRI BI-RADS® 3 lesions? Breast 2016; 27:1-7. [DOI: 10.1016/j.breast.2016.02.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Revised: 02/01/2016] [Accepted: 02/05/2016] [Indexed: 10/22/2022] Open
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Lavoué V, Fritel X, Antoine M, Beltjens F, Bendifallah S, Boisserie-Lacroix M, Boulanger L, Canlorbe G, Catteau-Jonard S, Chabbert-Buffet N, Chamming's F, Chéreau E, Chopier J, Coutant C, Demetz J, Guilhen N, Fauvet R, Kerdraon O, Laas E, Legendre G, Mathelin C, Nadeau C, Naggara IT, Ngô C, Ouldamer L, Rafii A, Roedlich MN, Seror J, Séror JY, Touboul C, Uzan C, Daraï E. Clinical practice guidelines from the French College of Gynecologists and Obstetricians (CNGOF): benign breast tumors – short text. Eur J Obstet Gynecol Reprod Biol 2016; 200:16-23. [DOI: 10.1016/j.ejogrb.2016.02.017] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Accepted: 02/11/2016] [Indexed: 10/22/2022]
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Lavoué V, Fritel X, Antoine M, Beltjens F, Bendifallah S, Boisserie-Lacroix M, Boulanger L, Canlorbe G, Catteau-Jonard S, Chabbert-Buffet N, Chamming's F, Chéreau E, Chopier J, Coutant C, Demetz J, Guilhen N, Fauvet R, Kerdraon O, Laas E, Legendre G, Mathelin C, Nadeau C, Thomassin Naggara I, Ngô C, Ouldamer L, Rafii A, Roedlich MN, Seror J, Séror JY, Touboul C, Uzan C, Daraï E. Tumeurs bénignes du sein : recommandations pour la pratique clinique du Collège national des gynécologues et obstétriciens français (CNGOF) – Texte court. ACTA ACUST UNITED AC 2015; 44:1049-64. [DOI: 10.1016/j.jgyn.2015.09.033] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2015] [Accepted: 09/18/2015] [Indexed: 11/29/2022]
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Lavoué V, Fritel X, Chopier J, Roedlich MN, Chamming's F, Mathelin C, Bendifallah S, Boisserie-Lacroix M, Canlorbe G, Chabbert-Buffet N, Coutant C, Guilhen N, Fauvet R, Laas E, Legendre G, Thomassin Naggara I, Ngô C, Ouldamer L, Seror J, Touboul C, Daraï E. [Clinical practice guidelines: Benign breast tumor--Aims, methods and organization]. J Gynecol Obstet Hum Reprod 2015; 44:898-903. [PMID: 26527015 DOI: 10.1016/j.jgyn.2015.09.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2015] [Accepted: 09/18/2015] [Indexed: 06/05/2023]
Abstract
Conversely to breast cancer, few data and guidelines are available to explore and manage benign breast disorders. Therefore, the Collège national des gynécologues et obstétriciens français (CNGOF - French College of Gynaecologists and Obstetricians) decided to establish clinical practice guidelines for benign breast tumour (BBT). CNGOF appointed a committee with responsibility for selecting experts, compiling questions and summarizing the recommendations. The summary of valid scientific data for each question analyzed by the experts included a level of evidence, based on the quality of the data available and defined accordingly rating scheme developed by the Haute Autorité de santé (French National Authority for Health).
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Affiliation(s)
- V Lavoué
- Service de gynécologie, CHU de Rennes, ER440, Oncogenesis, Stress and Signaling, labelisé Inserm, CRLCC Eugène-Marquis, université de Rennes 1, 35000 Rennes, France; Collège national des gynécologues et obstétriciens français, 91, boulevard Sébastopol, 75002 Paris, France.
| | - X Fritel
- Université de Poitiers, CIC 1402, CHU de Poitiers, 86021 Poitiers, France; CESP Inserm U1018, 94270 Le Kremlin-Bicêtre, France
| | - J Chopier
- Service de radiologie, hôpital Tenon, AP-HP, 4, rue de la Chine, 75020 Paris, France
| | - M-N Roedlich
- Service de radiologie, hôpital Hautepierre, 1, avenue Molière, 67100 Strasbourg, France
| | - F Chamming's
- Service de radiologie, hôpital européen Georges-Pompidou, AP-HP, 15, rue Leblanc, 75015 Paris, France
| | - C Mathelin
- Unité de sénologie, hôpital de Hautepierre, CHRU de Strasbourg, avenue Molière, 67200 Strasbourg, France
| | - S Bendifallah
- Inserm UMRS707, service de gynécologie-obstétrique et médecine de la reproduction, hôpital Tenon, AP-HP, 4, rue de la Chine, 75020 Paris, France
| | - M Boisserie-Lacroix
- Service de radiologie, centre régional de lutte contre le cancer Bergognié, 33000 Bordeaux, France
| | - G Canlorbe
- Service de gynécologie-obstétrique et médecine de la reproduction, hôpital Tenon, AP-HP, Inserm UMRS938, 4, rue de la Chine, 75020 Paris, France
| | - N Chabbert-Buffet
- Service de gynécologie-obstétrique et médecine de la reproduction, hôpital Tenon, AP-HP, 4, rue de la Chine, 75020 Paris, France
| | - C Coutant
- Service de chirurgie, centre régional de lutte contre le cancer Georges-François-Leclerc, 21000 Dijon, France
| | - N Guilhen
- Service de gynécologie-obstétrique, CHU de Poitiers, 2, rue de la Milétrie, BP 577, 86021 Poitiers cedex, France
| | - R Fauvet
- Service de gynécologie-obstétrique, CHU de Caen, université de Basse-Normandie, Inserm U1199, BIOTICLA, avenue de la Côte-de-Nacre, 14033 Caen cedex 09, France
| | - E Laas
- Service de gynécologie-obstétrique et médecine de la reproduction, hôpital Tenon, AP-HP, 4, rue de la Chine, 75020 Paris, France
| | - G Legendre
- Service de gynécologie-obstétrique, CHU d'Angers, CESP Inserm U1018, 49100 Angers, France
| | - I Thomassin Naggara
- Service de radiologie, hôpital Tenon, AP-HP, 4, rue de la Chine, 75020 Paris, France
| | - C Ngô
- Service de chirurgie cancérologique, gynécologique et du sein, hôpital européen Georges-Pompidou, AP-HP, université Paris Descartes, 15, rue Leblanc, 75015 Paris, France
| | - L Ouldamer
- Unité Inserm 1069, département de gynécologie, hôpital Bretonneau, centre hospitalier régional universitaire de Tours, faculté de médecine François-Rabelais, 2, boulevard Tonnellé, 37044 Tours, France
| | - J Seror
- Cabinet médical, 146, avenue Ledru-Rollin, 75011 Paris, France; Service d'échographie, hôpital Tenon, AP-HP, 4, rue de la Chine, 75020 Paris, France
| | - C Touboul
- Service de gynécologie-obstétrique, CHI, 40, avenue de Verdun, 94000 Créteil, France
| | - E Daraï
- Service de gynécologie-obstétrique et médecine de la reproduction, hôpital Tenon, AP-HP, Inserm UMRS938, 4, rue de la Chine, 75020 Paris, France
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Lippa N, Hurtevent-Labrot G, Ferron S, Boisserie-Lacroix M. Nipple discharge: The role of imaging. Diagn Interv Imaging 2015; 96:1017-32. [DOI: 10.1016/j.diii.2015.07.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Accepted: 07/05/2015] [Indexed: 11/30/2022]
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Boisserie-Lacroix M, Duguey-Cachet O, Stadelmaier N, Hurtevent-Labrot G, Jouneau J. Establishment of a consultation to announce the results of a breast biopsy. Diagn Interv Imaging 2014; 95:595-9. [PMID: 24618560 DOI: 10.1016/j.diii.2014.01.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
PURPOSE Establishment of post-breast biopsy consultations to announce the results. Evaluation of this system in order to help improve the practice. PATIENTS AND METHODS The radio-senologists benefited from continuing medical education for the in-house announcement. Fifty patients (with malignant results) received questionnaires comprising 13 items and the possibility of free and anonymous comments. RESULTS The authors present tools to help in the interview. Thirty-one questionnaires were returned by the patients and were analysed. Thirty patients (96.8%) considered the information provided as rather or fully sufficient, and only one considered that she did not have enough time to ask all of the questions she wanted to ask. Two patients (6.6%) found the scheduling of the subsequent appointments insufficient. The patients had a rather positive overall judgement about this consultation. CONCLUSION The radiologist may provide one of the consultations to announce the results, depending on their involvement in senology, their personal expertise and their integration in the care network.
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Affiliation(s)
- M Boisserie-Lacroix
- Unité de radio-sénologie, institut Bergonié, 229, Cours de l'Argonne, 33076 Bordeaux cedex, France.
| | - O Duguey-Cachet
- Département CARE (coordination-accompagnement-réhabilitation-éducation), institut Bergonié, 229, Cours de l'Argonne, 33076 Bordeaux cedex, France
| | - N Stadelmaier
- Département CARE (coordination-accompagnement-réhabilitation-éducation), institut Bergonié, 229, Cours de l'Argonne, 33076 Bordeaux cedex, France
| | - G Hurtevent-Labrot
- Unité de radio-sénologie, institut Bergonié, 229, Cours de l'Argonne, 33076 Bordeaux cedex, France
| | - J Jouneau
- Département qualité et gestion des risques, institut Bergonié, 229, Cours de l'Argonne, 33076 Bordeaux cedex, France
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Boisserie-Lacroix M, Bullier B, Hurtevent-Labrot G, Ferron S, Lippa N, Mac Grogan G. Correlation between imaging and prognostic factors: molecular classification of breast cancers. Diagn Interv Imaging 2014; 95:227-33. [PMID: 24508482 DOI: 10.1016/j.diii.2013.12.013] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The new molecular classification of breast cancers defines cancer sub-groups with a distinct prognosis and response to treatment. Studies on the literature deal with the imaging of each tumour sub-type. The radiologist should be familiar with them in order to adapt the care of an aggressive sub-type. In view of the current knowledge, the following have been significantly more often observed: mammographical spiculated mass with echogenic halo in luminal A sub-type; architectural distortion in luminal B sub-type; an irregular mass with indistinct margin comprising microcalcifications, with an abrupt interface in the sonography, or non-sonographic mass in the HER2 sub-type; a very hypoechogenic, lobulated mass with indistinct or microlobulated margin, with an abrupt interface, sometimes pseudo-benign, in the triple-negative sub-type.
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Affiliation(s)
- M Boisserie-Lacroix
- Unité de sénologie département d'imagerie médicale, institut Bergonié, 229, cours de l'Argonne, 33076 Bordeaux cedex, France.
| | - B Bullier
- Unité de sénologie département d'imagerie médicale, institut Bergonié, 229, cours de l'Argonne, 33076 Bordeaux cedex, France
| | - G Hurtevent-Labrot
- Unité de sénologie département d'imagerie médicale, institut Bergonié, 229, cours de l'Argonne, 33076 Bordeaux cedex, France
| | - S Ferron
- Unité de sénologie département d'imagerie médicale, institut Bergonié, 229, cours de l'Argonne, 33076 Bordeaux cedex, France
| | - N Lippa
- Unité de sénologie département d'imagerie médicale, institut Bergonié, 229, cours de l'Argonne, 33076 Bordeaux cedex, France
| | - G Mac Grogan
- Département de biopathologie, institut Bergonié, 229, cours de l'Argonne, 33076 Bordeaux cedex, France
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Bullier B, MacGrogan G, Bonnefoi H, Hurtevent-Labrot G, Lhomme E, Brouste V, Boisserie-Lacroix M. Imaging features of sporadic breast cancer in women under 40 years old: 97 cases. Eur Radiol 2013; 23:3237-45. [PMID: 23918218 DOI: 10.1007/s00330-013-2966-z] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2013] [Revised: 06/03/2013] [Accepted: 06/20/2013] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To evaluate characteristic features of mammography, ultrasound and magnetic resonance imaging (MRI) of sporadic breast cancer in women <40 years and to determine correlations with pathological and biological factors. METHODS A retrospective review of radiological, clinicopathological and biological features of sporadic breast cancers for women under 40 years at our institution between 2007-2012 covering 91 patients. Mammography was available for 97 lesions, ultrasound for 94 and MRI for 38. RESULTS The most common imaging features were masses, nearly all classified BI-RADS 4 or 5. On mammography microcalcifications alone accounted for 31 %, all suspicious. There were 42.6 % luminal B, 24.5 % luminal A, 19.1 % HER2-enriched and 10.6 % triple-negative (TN) tumours by immunohistochemistry. HER2 overexpression was correlated with the presence of calcifications at mammography (P = 0.03). TN cancers more often had an oval shape and abrupt interface at ultrasound and rim enhancement on MRI. MRI features were suspicious for all cancers and rim enhancement of a mass was a significant predictor of triple-negative tumours (P = 0.01). CONCLUSIONS The imaging characteristics of cancers in patients under 40 years without proven gene mutations do not differ from their older counterparts, but appear correlated to phenotypic profiles, which have a different distribution in young women compared to the general population.
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Affiliation(s)
- Bénédicte Bullier
- Department of Radiology, Institut Bergonié, Comprehensive Cancer Centre, F-33000, Bordeaux, France
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Boisserie-Lacroix M, Hurtevent-Labrot G, Ferron S, Lippa N, Bonnefoi H, Mac Grogan G. Correlation between imaging and molecular classification of breast cancers. Diagn Interv Imaging 2013; 94:1069-80. [PMID: 23867597 DOI: 10.1016/j.diii.2013.04.010] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The histological type of tumour according to the WHO: ductal, lobular, rare forms, is correlated with specific aspects of the imaging based on each type. This morphological classification was improved by knowledge of the molecular anomalies of breast cancers, resulting in the definition of cancer sub-groups with distinct prognoses and different responses to treatment: luminal A, luminal B, HER2 positive, basal-like, triple-negative. Studies are beginning to deal with the appearance of each sub-type in the imaging. It is now important for the radiologist to be familiar with them.
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Affiliation(s)
- M Boisserie-Lacroix
- Breast Imaging Unit, Department of Medical Imaging, Institut Bergonié, 229, cours de l'Argonne, 33076 Bordeaux cedex, France.
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Boisserie-Lacroix M, Macgrogan G, Debled M, Ferron S, Asad-Syed M, McKelvie-Sebileau P, Mathoulin-Pélissier S, Brouste V, Hurtevent-Labrot G. Triple-negative breast cancers: associations between imaging and pathological findings for triple-negative tumors compared with hormone receptor-positive/human epidermal growth factor receptor-2-negative breast cancers. Oncologist 2013; 18:802-11. [PMID: 23821326 DOI: 10.1634/theoncologist.2013-0380] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Triple-negative (TN) breast cancers have high malignancy potential and are often characterized by early systemic relapse. Early detection is vital, but there are few comprehensive imaging reports. Here we describe mammography, ultrasound, and magnetic resonance imaging (MRI) findings of TN breast cancers, investigate the specific features of this subtype, and compare the characteristics of TN breast cancers with those of hormone receptor (HR)-positive/human epidermal growth factor receptor (HER)-2-negative breast cancers. MATERIALS AND METHODS From July 2009 to June 2011, mammography and ultrasound findings of 210 patients with pathologically confirmed TN (n = 105) and HR-positive/HER-2-negative breast cancers (n = 105) were retrospectively reviewed from our institutional database. Ultrasound vascularity was notified in 88 cases and elasticity scores were notified in 49 cases overall. Thirty-five patients underwent MRI (22 TN and 13 HR-positive/HER-2-negative). Mammograms, ultrasound, and MRI were reviewed according to the Breast Imaging-Reporting and Data System (BI-RADS) lexicon and classification. RESULTS TN breast cancers were more likely to show round, oval, or lobulated masses with indistinct margins on mammography than HR-positive/HER-2-negative breast cancers. On ultrasound, TN tumors were more likely than HR-positive/HER-2-negative breast cancers to show circumscribed or microlobulated margins and no posterior acoustic features or posterior enhancement-positive. On MRI, TN cancers exhibited suspicious aspects more often than HR-positive/HER-2-negative cancers, often with rim enhancement-positiveHER-2 (84.6% of masses were classified BI-RADS 5). CONCLUSION This study is the first to describe findings on mammography, ultrasound, and MRI for TN breast cancers with a matched HR-positive/HER-2-negative control group. Several distinctive morphological features of these aggressive tumors are identified that can be used for earlier diagnosis and treatment, and ultimately to improve outcomes.
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Boisserie-Lacroix M, Plantade R. Repérages préopératoires mammo/échographiques. Imagerie de la Femme 2012. [DOI: 10.1016/j.femme.2012.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Taourel P, Boisserie-Lacroix M. Sofmis et la revue Imagerie de la femme : bien plus qu’un mariage de raison. Imagerie de la Femme 2012. [DOI: 10.1016/j.femme.2012.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Boisserie-Lacroix M, Mac Grogan G, Debled M, Ferron S, Asad-Syed M, Brouste V, Mathoulin-Pelissier S, Hurtevent-Labrot G. Radiological features of triple-negative breast cancers (73 cases). Diagn Interv Imaging 2012; 93:183-90. [PMID: 22421282 DOI: 10.1016/j.diii.2012.01.006] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
OBJECTIVES Triple-negative breast cancers generally occur in young women and they have the potential to be aggressive. It is important for this subtype of tumour to be detected early. We studied the appearance of 73 tumours on mammography, sonography and MRI in order to determine what specific features they showed on imaging. PATIENTS AND METHODS From July 2009 to December 2010, we retrospectively reviewed mammogram and sonogram images of 73 triple-negative cancers. Colour Doppler had been used to depict vascularisation in 34 cases and elastography score calculated in 17 cases. Sixteen patients had undergone MRI. The radiological description of these different modalities draws on the BI-RADS lexicon and categorisation. RESULTS On mammography, triple-negative cancers often presented as a round mass (59.3%) or an oval or lobulated mass (65%), with circumscribed (15%), microlobulated (12.5%), indistinct (55%) or occasionally spiculated margins (15%). On sonography, the vast majority of these cancers appeared as masses (92.8%) with occasional posterior acoustic attenuation (22.6%). MRI showed more suspicious images than the standard examinations, notably rim-enhancement (eight out of 12 masses). CONCLUSION . Radiological images appear as lobulated masses more readily, while on sonography posterior enhancement is shown more often than attenuation, and MRI finds rim-enhancement.
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Boisserie-Lacroix M, Debled M, Tunon de Lara C, Hurtevent G, Asad-Syed M, Ferron S. The inflammatory breast: management, decision-making algorithms, therapeutic principles. Diagn Interv Imaging 2012; 93:126-36. [PMID: 22305596 DOI: 10.1016/j.diii.2011.12.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Inflammatory syndrome is one of the rare emergency breast situations. Its etiology is benign, infectious in most cases. The clinical examination is often self-evident and suggests the diagnosis. But alone it is insufficient, and diagnostic tests are necessary to guide therapy. As essential as it is, mammography's limitations reinforce the benefit of ultrasonography, which in all cases reveals an abscess and has greater sensitivity for detecting a malignant tumor. If the etiology is benign, clinical signs will disappear with medical treatment, with no need for further investigation. While it is legitimate to initiate a trial treatment, it must not delay oncologic management, because of the severity of inflammatory cancer.
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Affiliation(s)
- M Boisserie-Lacroix
- Senology Unit, Medical Imaging Department, Institut Bergonié, 229, rue de l'Argonne, 33076 Bordeaux cedex, France.
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Boisserie-Lacroix M, Adenet C, Trillaud H. [Evaluation of suspicious nipple discharge with MRI: review of 50 cases]. ACTA ACUST UNITED AC 2011; 92:412-20. [PMID: 21621107 DOI: 10.1016/j.jradio.2011.03.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2010] [Revised: 12/06/2010] [Accepted: 03/17/2011] [Indexed: 11/28/2022]
Abstract
PURPOSE To determine the role of MRI in the evaluation and management of patients with suspicious nipple discharge and normal mammographic and US evaluation. PATIENTS AND METHODS A total of 50 patients with suspicious nipple discharge and normal mammographic and US evaluation prospectively underwent MRI. The first 16 patients underwent routine breast MRI, while MR-ductography with image fusion at the console was added for the last 34 patients. RESULTS In 22 of 25 high-risk and malignant lesions, MRI showed enhancement whereas it was normal in three cases. In 25 benign cases (resolution of discharge/benign non-proliferative breast disease), MRI was negative in 22 cases and falsely positive in three cases. CONCLUSION In this clinical setting, MRI shows excellent sensitivity, PPV and NPV. A negative result on MRI would support clinical follow-up as opposed to surgery.
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Boisserie-Lacroix M, Lebiez-Michel N, Cavagni P, Bentolila J, Laumonier H, Bouzgarrou M, Trillaud H. [Hormones and mammographic breast density]. ACTA ACUST UNITED AC 2008; 89:1196-203. [PMID: 18772804 DOI: 10.1016/s0221-0363(08)73930-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Breast constitutional density may be altered and increased (acquired density) by hormonal interventions such as hormone replacement therapy (HRT). The effects of endogenous (steroids, prolactin, insulin-like factors...) and exogenous (HRT, levonorgestrel IUD, tibolone, tamoxifen, SERMs) hormones will be reviewed. Continuous combined estrogen-progestin preparations are most likely to cause an increase in density. Estrogen alone and tibolone are less likely to cause an increase in density. The sensitivity and specificity of mammography are decreased, with increased risk of interval carcinoma and rate of short interval follow-up from false positive results. The issue with regards to interruption of the hormonal therapy prior to mammography, and the duration of the interruption, are discussed.
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Affiliation(s)
- M Boisserie-Lacroix
- Service de Radiologie, CHU Saint-André, 1 rue Jean Burguet, 33075 Bordeaux cedex, France.
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Boisserie-Lacroix M, Lebiez-Michel N, Cavigni P, Bentolila J, Laumonier H, Bouzgarrou M, Trillaud H. [Breast ultrasonography: an overview]. ACTA ACUST UNITED AC 2006; 34:1170-7. [PMID: 17140836 DOI: 10.1016/j.gyobfe.2006.10.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2006] [Accepted: 10/11/2006] [Indexed: 11/18/2022]
Abstract
The most important roles of ultrasound in breast imaging include the diagnosis of cysts and the characterization of masses that have been incompletely assessed by mammography. Ultrasonography techniques such as harmonic and compound imaging have recently been introduced and are more efficient than conventional imaging in terms of lesion conspicuity and the characterization of breast nodule. The BI-RADS classification is an important system for describing and classifying breast lesions. With this approach, a population of benign solid breast lesions that does not require biopsy can be accurately defined. Ultrasonography should be performed as first-line examination in juvenile, in pregnant women and in patients with inflammatory syndrome. Ultrasound can detect mammographically occult breast the way they develop.
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Affiliation(s)
- M Boisserie-Lacroix
- Service de radiologie (Docteur-Trillaud), CHU de Saint-André, 1, rue Jean-Burguet, 33075 Bordeaux cedex, France.
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Abstract
An essential component of the Cancer Plan is to improve the conditions of disclosure of a diagnosis of cancer to the patient. Providing information to patients is the phycisian's mission. The radiologist plays a crucial role in the multi disciplinary team.
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Affiliation(s)
- M Boisserie-Lacroix
- Unité de Sénologie Service de Radiologie Pr Trillaud, CHU Saint-André, 1 rue Jean Burguet, 33075 Bordeaux Cedex.
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Boisserie-Lacroix M, Dos Santos E, Lebiez-Michel N, Galtier JB, Bouzgarrou M, Trillaud H. [Mammography in younger women: interpretation of abnormal findings]. J Radiol 2004; 85:2143-4. [PMID: 15692433 DOI: 10.1016/s0221-0363(04)97795-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
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Boisserie-Lacroix M, Dos Santos E, Lebiez-Michel N, Galtier JB, Bouzgarrou M, Trillaud H. [Mammography in younger women: interpretation of abnormal findings]. J Radiol 2004; 85:2135-42. [PMID: 15692432 DOI: 10.1016/s0221-0363(04)97794-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
The aim of this paper is to report the mammographic predictive positive value by decade of age using the assessment categories described within the BI-RADS lexicon.
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Affiliation(s)
- M Boisserie-Lacroix
- Unité de Sénologie, Service de Radiologie, CHU Saint-André, 1, rue Jean-Burguet, 33075 Bordeaux.
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Abstract
Whether qualitative-classified or quantitative-measured, mammographic density, which changes according to physiological variations, is nowadays commonly recognized as a factor increasing the relative risk of breast cancer. The present review aims at clarifying the impact of menopausal hormonal therapies on mammographic density. Neither Tibolone nor Raloxifene seem to have any negative impact on mammographic density. In some instances, oestrogens-progestin hormonal replacement therapies may increase mammographic density and thus reduce sensitivity and specificity of screening mammograms. Shorter intervals between mammographies combined with additional physical examination and breast ultrasonography appear to be the best way to reduce interval cancers.
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Affiliation(s)
- G Boutet
- Cabinet de Gynécologie, 28 rue de Norvège 17000 La Rochelle
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Boisserie-Lacroix M, Dos Santos E, Belléannée G, Bouzgarrou M, Galtier JB, Trillaud H. La femme enceinte : difficultés diagnostiques. Imagerie de la Femme 2004. [DOI: 10.1016/s1776-9817(04)94798-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Boisserie-Lacroix M, Ranchon N. [Contribution of high resolution breast ultrasonography in the characterization of ambiguous mammograms]. Gynecol Obstet Fertil 2002; 30:147-53. [PMID: 11910885 DOI: 10.1016/s1297-9589(01)00283-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The near-field imaging capability of sonography equipment has recently and markedly improved. High-frequency ultrasonography can improve the specificity of clinically and mammographically detected abnormalities, and helps accurately distinguish benign solid nodules from indeterminate or malignant nodules. The aim of this distinction is to obviate surgical biopsy.
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Affiliation(s)
- M Boisserie-Lacroix
- Service de radiologie du Dr Trillaud, Hôpital Saint-André, CHU, 1, rue Jean Burguet, 33075 Bordeaux, France.
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Moiton M, Delbrel X, Béfar D, Boisserie-Lacroix M, Lebras M, Longy-Boursier M. Fasciite palmaire et aspects IRM. Rev Med Interne 2001. [DOI: 10.1016/s0248-8663(01)83505-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Eid S, Dos Santos E, Boisserie-Lacroix M, Grelet P, Rivel J. [Lactating adenoma: radiologic aspects. A case report]. J Radiol 2001; 82:264-7. [PMID: 11287859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
We report the US and MRI appearance in a patient with a giant lactating adenoma detected during pregnancy and followed-up for 12 months postpartum. The different imaging features of lactating adenomas are discussed, especially at US and MRI. We discuss also the role of core biopsy in diagnosing pregnancy associated breast masses.
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Affiliation(s)
- S Eid
- (1) Service de Radiologie, Hôpital Saint-André, 1, rue Jean Burguet, 33075 Bordeaux
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Boisserie-Lacroix M, Boutet G, Desforges J, Boudon N, Dos Santos E, Grelet P. [Prescription of hormone replacement therapy. Review on the management with abnormal mammography]. J Gynecol Obstet Biol Reprod (Paris) 1999; 28:808-16. [PMID: 10635483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
Mammography must be performed before restauring RHT. We discuss the radiological contrindications before RHT, and the predictive positive value of malignancy for stellate lesions, round opacities, diffuse microcalcifications, cluster of microcalcifications. Ultrasonography is essential for differentiating benign from malignant lesions. Diagnosis strategy (clinical follow-up, fine needle aspiration, biopsy, surgery) depends also on personal and familial history.
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Abstract
We report five adolescent girls with secondary breast tumours. All were imaged by US and the imaging findings have been analysed. Four girls had rhabdomyosarcoma as the primary malignant disease and one had leukaemia. US features were variable, but most of the cases showed heterogeneous nodules which were quite different from the usual benign lesions (fibroadenoma, abscess, cyst) encountered at this age. The metastases produced a variety of echo characteristics: masses with well-defined margins, hyperechoic foci and sonolucent or hypoechoic nodules with posterior attenuation or lacking posterior enhancement. One lesion was round and heterogeneous with a hyperechoic centre. These US findings in an adolescent girl suggest the need for fine-needle aspiration. Mammograms, when performed, never revealed microcalcifications and were quite difficult to analyse at this age, due to the dense glandular breast tissue.
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Affiliation(s)
- J F Chateil
- Service de Radiologie A, Hôpital Pellegrin, Bordeaux, France
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Boutet G, Boisserie-Lacroix M. [Cowden's disease in a young girl: mammographic problems]. J Gynecol Obstet Biol Reprod (Paris) 1995; 24:686-690. [PMID: 8568174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
A 14-year-old girl consulted for multiple breast nodules which were found to result from Cowden's disease, also called multiple hamartomatosis. Mammography and sonography examinations were completed with nuclear magnetic resonance imaging after injection of paramagnetic contrast product. Cowden's disease is a rare condition resulting in the development of tumors in genodermatous tissue; The cause remains unknown. In cases involving the breast, cutaneous lesions are markers of precancerous development since cancer occurs in 28 to 30% of these cases.
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Affiliation(s)
- G Boutet
- Cabinet de Gynécologie, La Rochelle
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