Prise en charge des atypies épithéliales du sein

While awaiting a molecular classification of breast epithelial atypia, the authors give some guidelines about their management, in reference to studies in literature and to their own experience at the Institut Bergonié. This experience is based on the analysis of 2,833 serially sectioned surgical breast biopsies performed for micro-calcifications without any palpable mass (median number of blocks per biopsy: 26) in patients with a long median follow-up (160 months). Some guidelines are given about the application of the WHO classification of atypical non invasive proliferative breast lesions, measurement of atypical ductal hyperplasia, management of patients with epithelial atypia on core needle biopsies and management of surgical biopsies corresponding to re excision to set out a small concomitant close cancer, present in nearly one third of the cases. Indeed, epithelial atypia could be more a risk marker of concomitant than subsequent cancer.