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New Milk Duct Test May Detect Breast Cancer Earlier

WebMD Health News
Reviewed by Gary D. Vogin, MD

April 26, 2001 -- A new breast cancer test that examines breast cells taken from the milk ducts sometimes can detect the disease earlier than mammography, the gold standard screening tool.

Though mammography is the most widely used screening tool for breast cancer, it does not detect all early breast cancer and is especially likely to miss small tumors in young women with dense breasts. Thus, researchers are looking for other screening tools to use alongside mammography.

The milk duct test, described in the April 28 issue of The Lancet,may be such a tool. That's because breast cancer often starts in the cells that line the milk ducts, study author Saraswati Sukumar, PhD tells WebMD.

In the milk duct test, called ductal lavage, the ducts are washed out with a saline solution that is injected through the nipple. The flushing loosens breast cells that are then withdrawn out again with the solution. The cells are then examined under the microscope. Women who have undergone ductal lavage say the procedure is uncomfortable but not painful.

Sukumar is senior investigator of a research project examining a new way to evaluate the cells obtained via ductal lavage as well as an associate professor of oncology and pathology and director of basic research at the Breast Cancer Program of the Johns Hopkins Oncology Center in Baltimore.

In the study, Sukumar and colleagues report that by looking for genetic abnormalities in the cells collected via ductal lavage, they were able to identify breast cancer in its very early stages with remarkable accuracy. They also were able to detect when cancer was not present.

Breast cancer specialist David Euhus, MD, says ductal lavage will not be a good method of screening all women for breast cancer -- the way mammography is used. One reason is that the lavage method only collects cells from a few of the 30 or so ducts in the breast, so it is easy to miss cancer. Another problem is that the procedure takes time and is quite expensive to perform. According to Euhus, who runs a high-risk clinic for breast cancer at the University of Texas Southwestern Medical Center at Dallas, the milk duct test will be most helpful in detecting disease in women known to be at high risk for breast cancer because of other factors, such as family history.

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