The use of ductal lavage as a screening tool in women at high risk for developing breast carcinoma

Background The purpose of the study was to determine if ductal lavage could predict the occurrence of breast cancer as well as further stratify patients at high-risk for developing breast cancer. Methods Ductal lavage was performed in 116 high-risk patients (Gail Risk score ≥1.7%, previous breast cancer, strong family history, previous suspicious biopsy specimen). If atypia or papillary cells were identified, a standard protocol of evaluation was initiated. Results Two hundred twenty-three lavages were performed on 116 patients. Twenty-seven lavages in 25 patients yielded atypical or papillary-like cells. The 15 patients who underwent further evaluation for atypia had no evidence of cancerous or precancerous lesions. All patients were followed-up: 2 developed breast cancer, both of whom had had normal previous lavage. No patient with abnormal lavage developed cancer during follow-up. Conclusions We find ductal lavage to be of limited value in the screening of high-risk patients and have removed it from our treatment algorithm.