Breast Cancer Detection
Excerpt By Alexa Pozniak, ABCNews.com

A promising new procedure detects breast cancer at its earliest stages, helping high risk women decide which preventative options are best for them.

Doctors have developed a diagnostic tool that will help determine the threat of breast cancer for women at high risk for the disease.

Women with a history of breast cancer in their family face a number of difficult decisions regarding how to prevent the disease from developing in themselves. Since a high-risk woman's options range anywhere from a "wait-and-see" approach to surgically removing both breasts, the ability to predict future cancer is paramount.

To improve breast cancer prediction and help make these decisions a little easier, doctors now report in the Journal of the National Cancer Institute that a new diagnostic tool called ductal lavage is safe, and well-tolerated by patients.

Simple Procedure

Ductal lavage is a simple, outpatient procedure that can detect cancer at its earliest stage within the breast ducts. Before the lavage, an anesthetic cream is applied to the nipple of the breast to numb the area.

A tiny catheter is gently inserted through the nipple into a milk duct openining and a small amount of anesthetic is flushed into the duct. Saline is then slowly delivered through the catheter to rinse the duct and collect cells. The ductal cell fluid is withdrawn through the catheter and sent to the lab for analysis.

The study of 507 high-risk women found that ductal lavage detected abnormal cells in 24 percent of the participants, all of whom had normal mammograms and clinical breast exams 12 months prior to enrollment.

Ninety-nine percent of all breast cancers originate from the ductal system or lobular system, which is what produces the milk in the breast, says Dr. Jennifer Sabol, a breast surgeon at Thomas Jefferson University Hospital in Philadelphia.

Women considered high-risk and who are trying to decide whether to undergo more frequent detection methods, use drug therapy or have surgery to reduce the risk of breast cancer need as much information about their breast health as possible, Dooley said.

"We've known for years that abnormal, or atypical, cells increase a woman's breast cancer risk four to five times, and the risk is even higher for women who also have a family history of breast cancer," said Dr. William C. Dooley, principal investigator of the study and medical director of the University of Oklahoma Breast Institute.

"The challenge has been in finding atypical cells since they can't always be seen or felt. Ductal lavage now provides a minimally invasive, more reliable way to search for them," adds Dooley

Comfort Level

The study also examined the level of comfort the participants experienced. The women were asked to rate their experience on a scale of 1 to 100; with 1 representing a painless experience, and 100 representing an extremely painful experience. The average response was 24, meaning most women did not find the procedure particularly uncomfortable.

Rosalyn Davis, of New Jersey, who has a family history of breast cancer, recently underwent the procedure and is glad she did.

"The results, which I just got the other day, certainly put my mind at ease for the time being," she said.

"I would recommend that women in this situation have this test done if their doctor recommends it," adds Davis. "It was much less painful than I had ever expected it to be. There was actually no pain involved."

Not a Substitute

Currently, ductal lavage is only being used on women at high risk. Dr. Sabol warns that although the procedure is very promising for detecting abnormal cells in the milk ducts, it should not take the place of a mammogram.

It's impossible with this system to cover the breast entirely like a screening mammogram does.

Reference Source 104

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