Ductal Lavage Testing for Breast Cancer Cells
Ductal lavage is a minimally invasive method of searching for abnormal cells inside the milk ducts, where most breast cancer begins. If abnormal cells are found, it provides physiological evidence of significantly increased breast cancer risk. Determining whether abnormal (or "atypical") cells are present can help high-risk women and physicians weigh the risks and benefits of options such as closer surveillance and risk reduction drug therapy.
Dr. Dario Francescatti, a breast surgeon at Rush-Presbyterian-St. Luke's Medical Center in Chicago, is one of a group of doctors in the country to provide ductal lavage for women at high risk for breast cancer.
"Ductal lavage is used only for women already at high-risk for breast cancer," said Dr. Francescatti. "By searching for physiological indicators of further elevated risk, ductal lavage functions similarly to a bone density test, which offers physiological information to women already at risk for osteoporosis."
Clinical studies done on ductal lavage have shown that the test identified abnormal cells in 24% of the participants who received it.
How ductal lavage is performed
A hair-thin catheter is inserted into
the milk duct to collect cells for testing.
Ductal lavage involves three steps: An anesthetic cream is applied to the nipple area. Gentle suction is used to help draw tiny amounts of fluid from the milk ducts up to the nipple surface. The fluid droplets that appear help locate the milk ducts' natural openings on the surface of the nipple.
Then, a hair-thin catheter is inserted into a milk duct opening on the nipple. A small amount of anesthetic is infused into the duct. Saline then is slowly delivered through the catheter to gently "rinse" the duct and collect cells. The ductal cell fluid is withdrawn through the catheter and deposited into a collection vial.
Finally, the sample is sent to a laboratory for analysis to determine whether the cells are normal, atypical or malignant.
"The entire procedure typically takes about 15-30 minutes and is done in an office setting," said Dr. Francescatti.
He pointed out that the presence of atypical cells does not necessarily mean that breast cancer will follow. "In fact, in most cases, these cells don't progress to cancer. Therefore, finding atypical cells is not necessarily the same as finding "pre-cancer," he said. But, he did stress that clinical studies have shown that the presence of atypical cells confers a five-fold increase in breast cancer risk.
Among women with a family history of breast cancer, the presence of atypical cells has been shown to increase relative risk 11- to 22-times.
Dr. Francescatti said that if ductal lavage identifies atypical cells in a high-risk woman, there are a number of ways to reduce her risk of developing breast cancer. Options include closer surveillance and risk reduction drug therapy. One of the advantages to ductal lavage is that it can be performed in the same milk duct repeatedly, allowing doctors to track cell behavior over time.
Return to-> Diagnosing Breast Cancer - Tools & Techniques
also see -> All About Ductal Lavage
Elsewhere on the Web:
Ductal Lavage and Risk Assessment of Breast Cancer - The Oncologist
Ductal Lavage to Detect Breast Cancer