A new screening technique, called ductal lavage, has proven successful in detecting cancerous or pre-cancerous cells in fluid extracted from a woman’s milk duct. Because most breast cancers begin in the breast milk ducts, ductal lavage can detect cancers that are not yet seen on mammography.
Ductal lavage is a safe and simple procedure that involves minimal discomfort. In fact, most women who have undergone the test report that it is less painful than a mammogram. First, a local anesthetic is utilized to numb the nipple. Then, fluid is drawn from the nipple with a breast pump. Through a small, flexible needle inserted about half an inch into the milk duct, a salt-water stream washes cells out of the ducts. These cells are then examined under a microscope to check for any abnormalities.
A recent clinical trial evaluated the effectiveness of ductal lavage as a screening procedure for breast cancer. Specifically, researchers examined whether ductal lavage could find abnormalities that were missed by standard screening tests. The study involved high-risk women who had normal mammograms within the past year. The results reported for 383 examined breasts show that ductal lavage found pre-cancerous and cancerous cells in 76 of the breasts. In two of these women, biopsies revealed ductal carcinoma in situ (DCIS) despite the fact that both of these women had normal mammograms both before and after the ductal lavage procedure. DCIS refers to cancer cells that are in the milk ducts, but have not penetrated the duct walls into the surrounding tissue. When cancer cells are found at such an early stage of development, the disease is highly curable.
Ductal lavage may prove to be a valuable procedure for detecting DCIS. Thus far, the results support using the procedure among high-risk women. More research is needed to determine the feasibility of using ductal lavage as a standard screening procedure. Women who are at a high risk for developing breast cancer may wish to speak with their physicians about the risks and benefits of participating in a clinical trial in which ductal lavage and other promising new screening techniques are being evaluated. eCancerTrials.com also performs personalized clinical trial searches on behalf of patients. (Northwestern University’s 2nd Annual Lynn Sage Breast Cancer Symposium, September 2000)