Recommandations pour la pratique clinique : tumeurs bénignes du sein – Objectifs, méthodes et organisation [Clinical practice guidelines: Benign breast tumor – Aims, methods and organization]

National audienceConversely 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)

Tumeurs bénignes du sein : recommandations pour la pratique clinique du Collège national des gynécologues et obstétriciens français (CNGOF) – Texte court [Benign breast tumors: Recommendations of Collège National des Gynécologues Obstétriciens Français (CNGOF) – Short text]

National audienceBreast sonography is required with mammogram to explore clinical breast mass (grade B), colored unipore breast nipple discharge (grade C), or mastitis (grade C). Bi-RADS system is recommended to describe and classify breast-imaging abnormalities. For breast abscess, a percutaneous biopsy is recommended in case of mass or persistent symptoms (grade C). For mastodynia, when breast imaging is normal, no MRI neither breast biopsy is recommended (grade C). Percutaneous biopsy is recommended for BI-RADS 4-5 mass (grade B). For persistent erythematous breast nipple or atypical eczema lesion, a nipple biopsy is recommended (grade C). For distortion and asymmetry, a vacuum core needle biopsy is recommended because of the risk of underestimation by simple core needle biopsy (grade C). For BI-RADS 4-5 microcalcifications without ultrasound signal, a vacuum core needle biopsy of at least 11 gauges is recommended (grade B); in the absence of microcalcifications on radiograph carrots, additional samples are recommended (grade B). For atypical ductal hyperplasia, atypical lobular hyperplasia, lobular carcinoma in situ, flat epithelial with atypia, radial scar, mucocele with atypia, surgical excision is commonly recommended (grade C). Expectant management is feasible after multidisciplinary concertation. For these lesions, when excision is not in sano, no new excision is recommended except for pleomorphic or with necrosis CLIS (grade C). For grade 1 phyllode tumour, in sano surgical resection is recommended; for grade 2 phyllode, 10-mm margins are recommended (grade C). For breast papillary without atypia, complete disappearance of the radiologic signal is recommended (grade C). For breast papillary with atypia, complete surgical excision is recommended (grade C)

On-site and in situ remediation technologies applicable to petroleum hydrocarbon contaminated sites in the Antarctic and Arctic

Petroleum hydrocarbon contaminated sites, associated with the contemporary and legacy effects of human activities, remain a serious environmental problem in the Antarctic and Arctic. The management of contaminated sites in these regions is often confounded by the logistical, environmental, legislative and financial challenges associated with operating in polar environments. In response to the need for efficient and safe methods for managing contaminated sites, several technologies have been adapted for on-site or in situ application in these regions. This article reviews six technologies which are currently being adapted or developed for the remediation of petroleum hydrocarbon contaminated sites in the Antarctic and Arctic. Bioremediation, landfarming, biopiles, phytoremediation, electrokinetic remediation and permeable reactive barriers are reviewed and discussed with respect to their advantages, limitations and potential for the long-term management of soil and groundwater contaminated with petroleum hydrocarbons in the Antarctic and Arctic. Although these technologies demonstrate potential for application in the Antarctic and Arctic, their effectiveness is dependent on site-specific factors including terrain, soil moisture and temperature, freeze–thaw processes and the indigenous microbial population. The importance of detailed site assessment prior to on-site or in situ implementation is emphasized, and it is argued that coupling of technologies represents one strategy for effective, long-term management of petroleum hydrocarbon contaminated sites in the Antarctic and Arctic