Ductal lavage and the clinical management of women at high risk for breast carcinoma: A commentary

Received June 28, 2001; revision received September 24, 2001; accepted October 1, 2001. Breast carcinoma arises in the epithelial cells lining the milk ducts and lobules that comprise the ductal system of the breast. Ductal lavage is a minimally invasive office procedure performed on women who are considered to be at high risk for breast carcinoma to collect breast ductal epithelial cells for cytologic analysis to provide further risk stratification. The procedure involves the insertion of a microcatheter approximately 1.5 cm into a nipple orifice after topical anesthesia; lavaging the cannulated ductal system with normal saline; and analyzing the collected lavage effluent for the presence of normal, atypical, or malignant breast ductal cells. The purpose of this commentary is to review the data supporting breast ductal cytology as a tool to provide high-risk women with individualized information regarding their risk of developing breast carcinoma, and to provide a discussion of clinical management options based on the results of ductal lavage cytology.