Ductal lavage is a screening method used in at-risk women for

breast cancer Breast cancer is cancer that develops from breast tissue. Signs of breast cancer may include a lump in the breast, a change in breast shape, dimpling of the skin, milk rejection, fluid coming from the nipple, a newly inverted nipple, or ...

detection. In this method, cells are collected from

milk duct Lactiferous ducts are ducts that converge and form a branched system connecting the nipple to the lobules of the mammary gland. When lactogenesis occurs, under the influence of hormones, the milk is moved to the nipple by the action of smooth mus ...

s in the

breast The breast is one of two prominences located on the upper ventral region of a primate's torso. Both females and males develop breasts from the same embryological tissues. In females, it serves as the mammary gland, which produces and sec ...

. The procedure involves inserting a

catheter In medicine, a catheter (/ˈkæθətər/) is a thin tubing (material), tube made from medical grade materials serving a broad range of functions. Catheters are medical devices that can be inserted in the body to treat diseases or perform a surgi ...

(tube) into the

nipple The nipple is a raised region of tissue on the surface of the breast from which, in females, milk leaves the breast through the lactiferous ducts to feed an infant. The milk can flow through the nipple passively or it can be ejected by smooth ...

, which releases a small amount of

salt water Saline water (more commonly known as salt water) is water that contains a high concentration of dissolved salts (mainly sodium chloride). On the United States Geological Survey (USGS) salinity scale, saline water is saltier than brackish w ...

into the duct. The water picks up breast cells and the entire fluid is then retrieved and sent to be examined for cells, which are checked under a

microscope A microscope () is a laboratory instrument used to examine objects that are too small to be seen by the naked eye. Microscopy is the science of investigating small objects and structures using a microscope. Microscopic means being invisi ...

. Apart from clinical

breast examination Breast examination, also known as clinical breast examination, is a physical examination performed by a medical professional on an individual presenting with signs and symptoms in a breast, periodically on some people with a family history of brea ...

and

mammography Mammography (also called mastography) is the process of using low-energy X-rays (usually around 30 kVp) to examine the human breast for diagnosis and screening. The goal of mammography is the early detection of breast cancer, typically through ...

, ductal lavage can also be used to detect

Procedure

Ductal lavage is a

non-invasive A medical procedure is defined as ''non-invasive'' when no break in the skin is created and there is no contact with the mucosa, or skin break, or internal body cavity beyond a natural or artificial body orifice. For example, deep palpation and p ...

screening procedure. It is used to detect precancerous and cancerous cells in the breast ducts. It is a safe and well-tolerated procedure. Some doctors might apply anesthetic cream to numb the nipple area. In ductal lavage, the doctor applies

suction Suction is the colloquial term to describe the air pressure differential between areas. Removing air from a space results in a pressure differential. Suction pressure is therefore limited by external air pressure. Even a perfect vacuum cannot ...

to the nipple in order to bring out fluid from the milk ducts that eventually end at the nipple. A micro-

is inserted into the milk duct and the fluid is washed into the duct to rinse out the cells. The fluid is then retrieved from the nipple and sent for laboratory evaluation. This procedure is also called a "Breast Pap-Smear" by some doctors.

Ductal Lavage and Detection for Breast Cancer

There is much controversy around whether or not does ductal lavage actually help detect breast cancer. Earlier researches, in particular, have deemed it has a good tool for

risk assessment Broadly speaking, a risk assessment is the combined effort of: # identifying and analyzing potential (future) events that may negatively impact individuals, assets, and/or the environment (i.e. hazard analysis); and # making judgments "on the ...

for breast cancer. Though a 2004 study led by researchers at

Northwestern Memorial Hospital Northwestern Memorial Hospital (NMH) is a nationally ranked academic medical center located on Northwestern University’s Chicago campus in Streeterville, Chicago, Illinois. It is the flagship campus for Northwestern Medicine and the primary ...

, which also appeared in the

Journal of the National Cancer Institute The ''Journal of the National Cancer Institute'' (''JNCI'') is a peer-reviewed medical journal covering research in oncology that was established in August 1940. It is published monthly by Oxford University Press and is edited by Patricia A. ...

, argued that ductal lavage might not be an effective method for detecting breast cancer. Seema Khan, M.D., the lead author of the study and the interim director of the Lynn Sage Comprehensive Breast Center and surgeon at Northwestern Memorial Hospital explained, "This study raises serious questions about the utility of ductal lavage as a cancer detection test and shows us that women should not be offered ductal lavage as a method of breast cancer detection. Mammography and physical examination remain the most effective methods of early detection. Ductal lavage does remain promising as a method for obtaining more information about the level of breast cancer risk."

References

External links

Ductal lavage
entry in the public domain NCI Cancer Dictionary Breast procedures {{oncology-stub