An investigational technique for gathering and analyzing cells from the breast's milk ducts could spot the earliest signs of cancer in women at high risk of the disease.

The technique, called ductal lavage, involves sending saline into the milk ducts via a catheter to flush out cells for analysis. Because most breast cancers arise in the lining of the milk ducts, abnormal cells found during ductal lavage could signal the beginning of cancer.

Researchers compared ductal lavage with another technique for gathering ductal cells called nipple aspiration, in which a fine needle is used to draw samples. The investigators found that

Ductal lavage garnered far more cells for study and spotted abnormal cells 3.5 times more often than nipple aspiration did.

Dooley's team studied 507 women who had recently had normal mammograms but were considered to be at high risk of developing breast cancer. More than half had a history of the disease, while others were at risk due to a combination of factors such as previous breast cancer, family history and genetic mutations linked to breast cancer.

Ductal lavage produced enough cells for testing for 78% of the women, while nipple aspiration did so for only 27%. Moreover, lavage detected abnormal cells in one quarter of the women, whereas nipple aspiration uncovered suspicious cells in only 6%.

However, it is still unclear whether a benign finding from ductal lavage means a woman is unlikely to develop breast cancer. The accuracy of the technique in pinpointing cancer is still under study. The women in this study, are being followed to see how the early ductal lavage findings relate to cancer rates.

Journal of the National Cancer Institute November 7, 2001;93:1624-1632