[When must a mastopathy at risk be operated on? The viewpoint of the clinician, the radiologist, the surgeon, and the anatomopathologist].

The mastopathy is said to be truly "at risk" only when an anatomopathological examination has singled out certain criteria. At present, there is no medical treatment, particularly a hormonal one, capable of preventing the evolution towards a breast cancer. The indication for an operation could be based on a real score taking into account the age, the family history, the pregnancies, the fatness, the endogenous hormonal balance and the exogenous hormonal supply. In fact, above all considerations is the local mammary state, "the major mastoses", where a joint analytical study of: the clinical state, the mammography, the thermography and the cytopuncture is essential. The possibility of carrying out micro-biopsies under local anaesthesia is also underlined. Finally, we retain two big types of indication: of necessity. A lesion for which a doubt exists must be operated upon. The radiological location constitutes a considerable progress. Of principle. Namely in women with a heavy family history of breast cancer, a fortiori if the mammographies reveal dense, heterogeneous aspects, difficult to follow. Finally, the women for whom a previous biopsy has revealed lesions with an evolution potential (lobe neoplasia, extensive atypical epitheliosis). In conclusion, the indications are not often easy and is usually the object of a study of each case individually.