Prise en charge des lésions malignes avant chirurgie : état de l'art de la collaboration radiologue pathologiste

In breast cancers, imaging staging must give precise information about the lesion type (mass, calcifications, etc.), the location with the relationships with the skin and deep planes and the nipple, the size (maximal diameter and “surgical” size), the number of lesions (single or multiple) and the staging of axillary lymph nodes. Biopsies must be performed for giving reliable evaluation of the grade and biomarkers (hormonal receptor and HER2 status, Ki 67); US-guidance and respect of the pre-analytic criteria (fixation) are the cornerstones of their reliability. Fine needle aspirations must be reserved to additional suspicious lesions near the index lesion (< 3 cm) and suspicious lymph nodes. In case of discordant profiles, repeated percutaneous biopsies or re-evaluation at surgery will be asked.