Study: Ductal Lavage Better for Diagnosis Than Nipple Aspiration

Ductal lavage can find atypical or malignant cells better than nipple aspiration in women who otherwise have a normal breast examination and mammography, according to researchers at the University of Oklahoma Health Sciences Center.

These findings will help guide prophylactic treatment in women at a high risk of developing breast cancer, according to the report published in the Journal of the National Cancer Institute.

Prior research reported that ductal lavage was safe and feasible. This new study shows that ductal lavage can provide samples adequate for diagnosis in 78 percent of women, compared with 27 percent of samples obtained through nipple aspiration fluid.

Researchers studied 426 high-risk women who had undergone mammography and a clinical breast examination, showing no signs of breast cancer. Investigators found that ductal lavage was 3.5 times more likely than nipple aspiration to result in a cell diagnosis and was almost 5 times more likely to result in a higher grade abnormal diagnosis if at least mildly atypical cells were found.

On a scale of 0 to 100, the women in the study rated ductal lavage a "24" in terms of the pain involved with the procedure, with 0 being painless and 100 being painful.

Investigators suggest that ductal lavage is best used in women who were recently diagnosed with breast cancer in one breast with the other breast appearing normal.

If a ductal lavage is done on the apparently normal breast and atypical cells are found, that could factor in what treatment is given, including whether or not to use tamoxifen. Researchers also believe that the results of ductal lavage could be helpful for women considering prophylactic mastectomy by giving them more information on status of their risk.

Other Sources: Journal of the National Cancer Institute