Ductal Lavage for Breast Cancer Risk Assessment

Lisa A. Newman, MD, MPH, FACS, Cassann Blake, MD

Cancer Control. 2002;9(6)

Conclusions

Ductal lavage is promising as a risk assessment adjunct. It is a minimally invasive procedure that is well-tolerated by patients, and it is an additional mechanism for identifying women who harbor atypical hyperplasia in their breast ductal system. Ductal lavage is therefore a potentially valuable method of estimating individualized risk, and it can identify women who may derive a significant benefit from risk reduction strategies such as chemoprevention. As we develop a better understanding of the molecular changes that occur during breast cancer pathogenesis, we are likely to identify other molecular markers that may be detected in ductal fluid, and these markers may become important in assessing risk as well as in monitoring response to treatment for patients with an established breast cancer diagnosis.

1 2 3 4 5 6 7

Next Section

Acknowledgments

The authors gratefully acknowledge the assistance of Shashan Madan, MD, Department of Pathology, Wayne State University, for cytology and photography support in this project.

Reprint Address

Lisa A. Newman, MD, University of Michigan, 1500 East Ann Arbor Drive, 3308 Cancer Center, Ann Arbor, MI 48109-0932. E-mail: lanewman@umich.edu.

No significant relationship exists between the authors and the companies/organizations whose products or services may be referenced in this article.

The print version of this article was originally certified for CME credit. For accreditation details, contact: H. Lee Moffitt Cancer Center & Research Institute, 12902 Magnolia Drive, Tampa, FL 33612. Telephone: (813) 632-1349. Fax: (813) 903-4950. Email: ccjournal@moffitt.usf.edu.

Cite this: Ductal Lavage for Breast Cancer Risk Assessment - Medscape - Nov 01, 2002.

Table. Association of Atypical Hyperplasia With Relative Risk for Breast Cancer: Selected Studies
Author	No. of Patients	Selection Criteria	Median Follow-up	% Atypia	Method of Detection	Breast Cancer Relative Risk (95% Confidence Interval)
Fabian et al^[6] 2000	480	University of Kansas patients with high risk via FH/PH breast cancer or history of atypical hyperplasia/ductal carcinoma in situ	45 mos	12.0*	Periareolar FNAs for cytology	5.02 (2.01-12.56)
Wrensch et al^[3] 2001	3,633 (Group 1)	Group 1: UCSF BCDDP participants	21 yrs (Group 1)	2.4	Nipple aspirate fluid	2.4 (1.6-3.7)
Wrensch et al^[3] 2001	3,271 (Group 2)	Group 2: UCSF volunteers	9 yrs (Group 2)	2.4	Nipple aspirate fluid	2.8 (1.5-5.5)
Wrensch et al^[2] 1992	2,343	General screening population	12.7 yrs	2.0	Nipple aspirate fluid	4.9 (1.7-13.9)
Dupont et al^[7] 1999	9,494	Vanderbilt University patients with biopsy-proven benign breast disease	20 yrs	3.0	Surgical biopsy specimens	3.58 (2.6-5.0)
Bodian et al^[8] 1993	1,799	Haagensen patient population from Columbia-Presbyterian Medical Center with biopsy-proven benign breast disease	20.6 yrs	19.0	Surgical biopsy specimens	3.0 (1.5-6.0) (moderate/severe atypia)
Bodian et al^[8] 1993	1,799		20.6 yrs	19.0	Surgical biopsy specimens	2.3 (1.6-3.4) (mild atypia)
Hutchinson et al^[9] 1980	1,053	Private practice patient population with biopsy-proven benign breast disease	12.9 yrs	3.1	Surgical biopsy specimens	2.85 (0.34-10.28)
Carter et al^[10] 1988	16,692	BCDDP participants with history of biopsy-proven benign breast disease	8.3 yrs	7.8	Surgical biopsy specimens	3.0 (2.1-4.1)
Dupont et al^[11] 1985	3,303	History of biopsy-proven benign breast disease	17 yrs	3.6	Surgical biopsy specimens	All: 5.3 (3.1-8.8)
						With FH of breast cancer: 8.9 (4.8-17)
						Without FH of breast cancer: 3.5 (2.3-5.5)
London et al^[12] 1992	121 (cases)	Nurses Health Study participants with either cancer or biopsy-proven benign breast disease	9 yrs	22.3 (cases)	Surgical biopsy specimens	All: 3.7 (2.1-6.8)
	488 (controls)			9.6 (controls)		With FH of breast cancer: 7.3 (1.1-50.1)
	488 (controls)			9.6 (controls)		Without FH of breast cancer: 3.7 (1.9-7.0)
McDivitt et al^[13] 1992	433 (cases)	Cancer and Steroid Hormone Study participants with either cancer or biopsy-proven benign breast disease	N/A	15.9 (cases)	Surgical biopsy specimens	Odds ratio 2.6 (1.6-4.1)
McDivitt et al^[13] 1992	261 (controls)		N/A	10.0 (controls)	Surgical biopsy specimens	Odds ratio 2.6 (1.6-4.1)
Palli et al^[14] 1991	62 (cases)	Women from Florence, Italy, breast cancer screening program	N/A	17.7 (cases)	Surgical biopsy specimens	Odds ratio 13.0 (4.1-41.7)
Palli et al^[14] 1991	315 (controls)	Women from Florence, Italy, breast cancer screening program	2.2 (controls)	17.7 (cases)	Surgical biopsy specimens	Odds ratio 13.0 (4.1-41.7)
Krieger and Hiatt^[15] 1992	2,731	San Francisco, California, women with biopsy-proven benign breast disease	16 yrs	12.0	Surgical biopsy specimens	Rate ratio 7.2 (Black-Chabon score 5/severe atypia)
Dupont et al^[16] 1993	95 (cases)	BCDDP mammography screening program participants	N/A	14.7 (cases)	Surgical biopsy specimens	Odds ratio 4.3 (1.7-11)
Dupont et al^[16] 1993	227 (controls)	BCDDP mammography screening program participants	N/A	4.4 (controls)	Surgical biopsy specimens	Odds ratio 4.3 (1.7-11)
Byrne et al^[17] 2000	133 (cases)	Nurses Health Study participants with either cancer or biopsy-proven benign breast disease	N/A	25.6 (cases)	Surgical biopsy specimens	Odds ratio 3.6 (2.0-6.4)
Byrne et al^[17] 2000	610 (controls)		N/A	11.8 (controls)	Surgical biopsy specimens	Odds ratio 3.6 (2.0-6.4)

Comments

Commenting is limited to medical professionals. To comment please Log-in.

Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.

processing....

Ductal Lavage for Breast Cancer Risk Assessment

Conclusions

Tables

References

Authors and Disclosures

Authors and Disclosures

Comments

Most Popular Articles

Email This

Feedback