Lavage Testing for Breast Cancer Cells
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.
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.
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."
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.
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cell fluid is withdrawn through the catheter and deposited into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
entire procedure typically takes about 15-30 minutes and is done
in an office setting," said Dr. Francescatti.
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
women with a family history of breast cancer, the presence of atypical
cells has been shown to increase relative risk 11- to 22-times.
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.
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About Ductal Lavage
on the Web:
Ductal Lavage and Risk Assessment of Breast Cancer - The Oncologist
Lavage to Detect Breast Cancer