Ductal
Lavage: An Introduction 
The
milk ducts, the part of the breast right behind the nipple, is
where breast cancer usually starts.
It
can take up to ten years for cells in the ducts to change from
atypical to cancer and form a lump large enough to feel or to
be found on a mammogram.
If
cancer could be found when cells in the ducts begin to change,
it could be treated at the earliest stages. Imagine being able
to detect cancerous changes years before a lump would signal breast
cancer. That
is what ductal lavage is aiming for.
Lavage
means "to wash" and that is what this procedure
does. Anesthetic cream is applied to the breast and a tiny suction
device is placed over the nipple. A small amount of fluid is aspirated
or drawn from the milk ducts. This helps locate the duct openings
in the nipple. Next, a very thin catheter is inserted into the
opening of the duct, fluid is pushed in and then drawn out. This
fluid contains cells from inside the ducts. It is examined in
a lab and any cell changes are noted.
It
sounds so simple. Why didn't anyone think of this years ago?
It
seems that they did. A doctor in Uruguay tried a similar procedure
in the 1940s and George Papanicolaou - you know him from the PAP
smear that detects precancerous changes in the cervix - worked
with fluid from the breast in the 1950's. There have been others,
but the moving force behind the current test is Dr. Susan M. Love,
MD, an adjunct professor of surgery at UCLA, and co-founder and
director of the National Breast Cancer Coalition.
A
breast cancer specialist and advocate, she is one of the most
respected authorities in the field today. It seemed to her that
there ought to be a better way to diagnose breast cancer - on
the order of the PAP smear used to detect other gynecological
cancers. Her instincts and research led to the development of
the current procedure and the founding of ProDuct
Health.
In
an interview about ductal lavage she said, "When
you get breast cancer you only get it in one ductal system, not
in the whole breast. . . . And my hope is that with ductal lavage
we will go into the next level and be able to just squirt something
down that ductal system and clean it out and never get to surgery
and radiation and chemotherapy."
