Breast Ductal Lavage
To obtain nipple aspiration fluid (NAF), a pump and/or a syringe connected to a suction cup is applied to the nipple and the aspirated fluid is collected using a capillary tube. This procedure yields NAF in 59%–99% of women. A volume of 20–30μl of fluid can be obtained (range 1–200). About 77% of the cells of NAF are foam cells of macrophage derivation, and only 13% are ductal epithelial cells (median 120 cells/ duct). Criteria for evaluation of NAF were developed in the mid-1970s and are similar to the criteria used for evaluation of breast FNA material. The cytologic findings in NAF from 2,701 volunteer women with no family history of breast cancer and no breast carcinoma at the time of enrollment were analyzed prospectively. The overall incidence of breast cancer in this cohort was 4.4% after median follow-up of 12.7 years. In this study, both incidence and relative risk of breast cancer increased with increasing severity of cytologic diagnosis of the NAF (Table 6.1). Although the relative risk of breast cancer associated with abnormal NAF was reduced in an updated analysis of the data, these results have generated much interest in the use of mammary cytology for the evaluation of breast cancer risk.
KeywordsBreast Cancer Risk Ductal Cell Atypical Ductal Hyperplasia Ductal Lavage Usual Ductal Hyperplasia
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- Dooley WC, Ljung BM, Veronesi U, Cazzaniga M, Elledge RM, O’Shaughnessy JA, Kuerer HM, Hung DT, Khan SA, Phillips RF, Ganz PA, Euhus DM, Esserman LJ, Haffty BG, King BL, Kelley MC, Anderson MM, Schmit PJ, Clark RR, Kass FC, Anderson BO, Troyan SL, Arias RD, Quiring JN, Love SM, Page DL, King EB: Ductal lavage for detection of cellular atypia in women at high risk for breast cancer. J Natl Cancer Inst 2001, 93:1624–1632.PubMedGoogle Scholar