Ductal Lavage Screening for Pre-Cancerous and Cancerous Breast Cells

Breast Ducts and Lobes.  Pam Stephan

Something I hadn't heard of:

Updated January 29, 2013.

What is Ductal Lavage?:

Ductal Lavage has been referred to as the "Pap smear for the breast." With a very tiny tube, fluid can be sampled from the breast ducts, and examined under a microscope or screened at the molecular level for cancer cells.

Who needs this test?:

Women who are at high risk for breast cancer should ask their doctor if this test would help determine whether they may have a pre-cancerous condition, or if they have breast cancer cells present in the breast ducts.

How ductal lavage is done:

The nipple has many milk ducts that open onto its surface. A very tiny tube is inserted into one (or more) of these ducts, and intense suction is applied to the nipple. Some saline solution (mild salt water) is sent through the tube and into the duct, then washed out again, carrying with it a sample of cells from the duct tissue.

Does this test hurt?:

You will feel suction on your nipple - without it, the test won't work properly. You may feel a slight bit of poking sensation when the tube is being positioned and placed into your nipple. The tiny tube which is inserted in through the nipple should not be painful. If it is, let your doctor or nurse know about it.

How are the duct cell samples screened for breast cancer?:

There are now two ways the cells can be screened:

• microscopic pathology - the cells will be viewed under a microscope by a pathologist, and visually compared for irregular shape. Cancer cells have a particular shape which sets them apart from healthy cells.

• cytopathology - the cells will be separated from the saline wash, and sorted for chemical tags in their DNA that indicate whether or not they are cancerous.

What are the advantages?:

This is a non-surgical technique, and therefore less invasive than a biopsy. It may be done during an office visit, so it should cost less than a biopsy, and will not leave any scars. Recovery time, if needed, should be very quick.

What are the disadvantages?:

While ductal lavage can help determine if breast cancer is present in the ducts, it cannot show us precisely where the cancer is living. So, if the results of your test come back positive for ductal carcinoma, you will also need a dagnostic mammogram and perhaps an ultrasound as well, in order to locate the actual site of the cancer.