Ductal Lavage Useful in Cases of Lobular Neoplasia


BOSTON — Ductal lavage is technically feasible in patients diagnosed with lobular neoplasia, reported Marie Ward, M.D.

The minimally invasive procedure yields a sufficient amount of ductal epithelial cells for a determination of atypia and therefore can help further stratify patients who are at risk for developing breast cancer, Dr. Ward said in a poster presentation at a breast cancer conference sponsored by Harvard Medical School.

Lobular neoplasia, or lobular carcinoma in situ, refers to the entire spectrum of atypical epithelial proliferations in the milk-producing lobules of the breast. The condition is not considered a cancer per se; however, women who are diagnosed with it are at a higher risk of developing breast cancer later in life.

While ductal lavage is indicated in women at high risk for breast cancer, its use in women with lobular neoplasia specifically has never been examined, Dr. Ward said.

To investigate whether the ductal lavage technique could extract enough cellular material to be useful in the diagnosis and management of lobular neoplasia and to determine the incidence of abnormal lavage findings in patients with the condition, Dr. Ward and her colleagues at the Columbia University Comprehensive Breast Center in New York conducted a feasibility pilot study.

Using an outcomes database called the Ductal Lavage Outcomes Tracking System, the investigators identified 31 women with lobular neoplasia who underwent ductal lavage. The database showed that the procedure retrieved sufficient cellular material in all except 2 of the 31 women, whose average age was 52.5 years.

Of the 29 women from whom sufficient cellular material was collected, 19 had benign cytology findings. The researchers said 3 of the women had evidence of mild atypia. Moderate atypia was not noted for any of the women, and the findings were unreported or incomplete for seven of the women, Dr. Ward noted.

The results of the pilot study suggest that “ductal lavage may assist in risk stratification of this high-risk group, which in turn can enable clinicians and patients to make more accurate decisions regarding risk-reduction strategies,” said Dr. Ward.

Next Article: