© 2001 by Oxford University Press
Journal of the National Cancer Institute, Vol. 93, No. 21, 1585,
November 7, 2001
© 2001 Oxford University Press
MEMORANDUM FOR: Science Writers and Editors on the Journal Press List
Ductal Lavage Demonstrates Ability to Find Atypical Breast Cells in High-Risk Women
November 1, 2001 (EMBARGOED FOR RELEASE 4 P.M. ET November 6)
Ductal lavage, a new method of collecting breast cells from the milk ducts, can be used to find atypical breast cells in high-risk women.
William Dooley, M.D., at the University of Oklahoma Health Sciences Center, and colleagues at 19 participating centers, report that using ductal lavage, atypical cells were found in 24% of women who were at high risk for breast cancer. In other long-term studies, atypical cells have been shown to increase a woman’s breast cancer risk. The authors concluded that ductal lavage results can aid in clinical decision making about risk-reduction therapy and ongoing surveillance. The study results appear in the Nov. 7 issue of the Journal of the National Cancer Institute.
The authors also reported that ductal lavage found atypical cells 3.5 times more often than nipple aspiration, the only other minimally invasive breast cell collection technique. Compared with nipple aspiration, ductal lavage also yielded a larger number of cells. Ductal lavage collected a median of 13,500 epithelial cells per duct. In contrast, nipple aspiration collected an average of 120 epithelial cells per breast.
The study involved 507 high-risk women, including 291 with a history of breast cancer and 199 with other factors that put them at elevated risk. All had normal mammograms and clinical breast examinations within 12 months prior to enrollment. For all participants, nipple aspirate fluid (NAF) was collected using a modified breast pump and analyzed for abnormal cells. Subsequently, ductal lavage was performed on all NAF-yielding ducts. During ductal lavage, a thin microcatheter is inserted into the ductal opening and breast cells are collected through a saline rinse. All ductal lavage samples were compared with corresponding NAF samples for cell yield and cytologic diagnoses.
Compared with nipple aspiration, the authors report that ductal lavage was notably more reliable in producing samples that were sufficient for diagnosis. Only 27% of nipple aspiration samples were adequate for diagnosis, whereas 78% of samples collected by ductal lavage alone were adequate.
Subjects were asked to rate their ductal lavage experience on a scale of 0 to 100, with 0 being painless and 100 being painful. The median response was 24, indicating that most subjects found ductal lavage tolerable.
The researchers conclude that ductal lavage is a safe procedure that can determine the presence of atypical cells. Finding atypical cells can be useful in discussing decisions between high-risk women and their physicians regarding medical options such as closer surveillance, tamoxifen, and prophylactic mastectomy.
Contact: Leslie Gamble, University of Oklahoma, (405) 271-3255; fax: (405) 271-3323; Leslie-Gamble{at}ouhsc.edu.
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Dooley WC, Ljung B-M, Veronesi U, Cazzaniga M, Elledge RM, O’Shaughnessy JA, et al. Ductal lavage for detection of cellular atypia in women at high risk for breast cancer. J Natl Cancer Inst 2001;93:1624–32.
Note: This memo to reporters is from the Journal staff and is not an official release of the National Cancer Institute (NCI) or Oxford University Press (OUP) nor does it reflect NCI or OUP policy. In addition, unless otherwise stated, all articles and items published in the Journal reflect the individual views of the authors and not necessarily the official points of view held by NCI, any other component of the U.S. government, OUP, or the organizations with which the authors are affiliated. Neither NCI nor any other component of the U.S. government nor OUP assumes any responsibility for the completeness of the articles or other items or the accuracy of the conclusions reached therein.
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