Sensitivity of ductal lavage to detect breast cancer

ABSTRACT

The use of ductal lavage for cancer detection is based on the premise that fluid-yielding ducts are the ducts most likely to contain disease, and when these ducts are lavaged, cytologic findings will reflect the disease present. Ductal lavage sensitivity can be improved by the use of ductoscopy which allow direct visualization of the intraductal lesions and more distal exploration of the ductal tree. Ductoscopy and ductal lavage were performed in the operating room before mastectomy on 25 women with known breast cancer. When ductal lavage show sufficient cellularity for cytologic diagnosis, the lavaged duct was injected with patent blue dye. Histologic findings in ducts with and without dye were recorded. Associations between cytologic and histologic results were examined. Both cytologic and histologic materials were obtained from 17 [85%] of 20 ducts with sufficient cellularity and in 12 [48%] of 25 breasts. Sensitivity of ductal lavage cytology was 42.8% [3 cytologically positive ducts of 7 dye-containing ducts with histologically confirmed cancer]. Ductal lavage can detect breast cancer in 12% of the total study population [3 breast of the total study 25 breast]. In 22 cases with fluid yielded ducts; ductal lavage can detect breast cancer in 13.6%. The sensitivity of ductal lavage to detect breast cancer increase at the level of ductal analysis and can detect cancer in 21.9% of the total duct yielded fluids. In breasts with cancer, ductal lavage appears to have low sensitivity for cancer detection. The findings of our study do not support the premise that ductal lavage is an effective tool for the detection of breast cancer