ASBrS-SBI Guidelines for Management of Benign Breast Disease

Public Comment

The American Society of Breast Surgeons (ASBrS) and Society of Breast Imaging (SBI) are developing evidence-informed, clinical consensus guidelines for the management of four benign breast disease entities. ASBrS and SBI are publishing these guidelines to provide trusted, actionable decision support to clinicians who manage the treatment of benign breast disease. The guidelines presented here for public comment represent the first two disease entities: 1) benign fibroepithelial lesions including fibroadenomas, fibroepithelial lesions and benign phyllodes tumors and 2) infectious and inflammatory conditions of the breast.

These clinical consensus guidelines were developed using a modified Delphi consensus methodology. For each guideline, 4 experts in the field prepared recommendation statements related to the management of these diseases, informed by the findings of a systematic literature review. Consensus panels (10-11 members selected from the ASBrS membership including advanced practice providers, a pathology representative, 1-2 breast imaging representatives from SBI, and a patient advocate) participated in an initial round of ratings; a facilitated consensus meeting; and a final round of ratings. A priori scoring was used to determine consensus for each recommendation (resulting in strong consensus, consensus, or no consensus). ASBrS and SBI intend to publish these clinical consensus guidelines in a peer reviewed journal that will reach an audience that will benefit from this guidance.

Public comment is the final step in the consensus approach to the development of these guidelines. Public comments will be reviewed and incorporated into the final publication as warranted. There are spaces to comment on each recommendation statement as well as to make overall comments about the guidelines. Please provide references to support comments when relevant. The ASBrS encourages all stakeholders to provide feedback to produce a robust public comment. Public comment will close on October 31, 2024.

A link to each draft clinical consensus guideline and survey is below.

• Fibroepithelial Lesions (FEL) and Benign Phyllodes Tumors (BPT) 
• Fibroadenoma 
• Lactational Mastitis 
• Granulomatous Mastitis (GM) and Idiopathic Granulomatous Mastitis (IGM) 
• Periductal Mastitis with Squamous Metaplasia of Lactiferous Ducts (PDM-SMOLD) also known as Zuska’s Disease 

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