1097-0142/asset/cover.gif?v=1&s=a7299bc18f075294c232ade468773cd0672bd470 "Cancer")
Fax: (214) 648-7965
1097-0142/asset/olbannerleft.gif?v=1&s=ca681f5719430b26e1bc15e9ea4c9fc0a7110104)
1097-0142/asset/olbannerright.gif?v=1&s=8142566facf7e76aef9be6c51162a2e920b3b9f9)
Original Article
You have full text access to this OnlineOpen article
Reproducibility of cytologic atypia in repeat nipple duct lavage
Article first published online: 31 JAN 2005
DOI: 10.1002/cncr.20884
Copyright © 2005 American Cancer Society
Additional Information
How to Cite
Johnson-Maddux, A., Ashfaq, R., Cler, L., Naftalis, E., Leitch, A. M., Hoover, S. and Euhus, D. M. (2005), Reproducibility of cytologic atypia in repeat nipple duct lavage. Cancer, 103: 1129–1136. doi: 10.1002/cncr.20884
- †
Fax: (214) 648-7965
Publication History
- Issue published online: 2 MAR 2005
- Article first published online: 31 JAN 2005
- Manuscript Accepted: 28 OCT 2004
- Manuscript Revised: 19 OCT 2004
- Manuscript Received: 4 AUG 2004
Funded by
- Department of Defense Breast Cancer Research Program. Grant Number: DAMD17-01-1-0421
- Abstract
- Article
- References
- Cited By
Keywords:
- breast neoplasms;
- precancerous conditions;
- nipples;
- epithelial cells
Abstract
BACKGROUND
It is believed that atypical cells identified by nipple duct lavage (NDL) indicate an increased risk for breast carcinoma similar to atypical ductal hyperplasia diagnosed by tissue biopsy, but many basic performance characteristics of NDL currently are undefined.
METHODS
NDL was performed in 108 patients unselected for breast carcinoma risk and then was repeated after 2–14 months (median, 8 months) if the initial lavage was classified as atypical. Breast magnetic resonance images (MRIs) were obtained from a subset of patients who had atypical lavage results.
RESULTS
Marked atypia was diagnosed in 22% of 36 breasts with an incident carcinoma compared with 7% of 172 unaffected breasts (P = 0.01). After excluding breasts with an incident carcinoma, there were 32 patients (30%) with either mild or marked atypia. The lavage was repeated in 23 of these women, and the second lavage was classified as atypical in 48%. Neither marked atypia on the initial lavage nor a 5-year Gail risk ≥ 1.7% predicted atypia on repeat lavage, but there was a trend for improved reproducibility when the atypia initially was diagnosed in a fluid-producing duct. MRIs were abnormal in 13% of 24 breasts with an atypical lavage, and ductal carcinoma in situ was diagnosed subsequently in 1 breast.
CONCLUSIONS
Atypia frequently is diagnosed by NDL, but the reproducibility of repeat lavage is low. Lavage atypia may be physiologic or artifactual rather than pathologic in many instances. Marked atypia occasionally may represent mammographically occult ductal carcinoma in situ. Cancer 2005. © 2005 American Cancer Society.