Tolerability of breast ductal lavage in women from families at high genetic risk of breast cancer

Clinical Genetics Branch, National Cancer Institute, NIH, Rockville, MD, USA.
BMC Women's Health (Impact Factor: 1.5). 07/2009; 9(1):20. DOI: 10.1186/1472-6874-9-20
Source: PubMed


Ductal lavage (DL) has been proposed as a minimally-invasive, well-tolerated tool for obtaining breast epithelial cells for cytological evaluation of breast cancer risk. We report DL tolerability in BRCA1/2 mutation-positive and -negative women from an IRB-approved research study.
165 BRCA1/2 mutation-positive, 26 mutation-negative and 3 mutation unknown women underwent mammography, breast MRI and DL. Psychological well-being and perceptions of pain were obtained before and after DL, and compared with pain experienced during other screening procedures.
The average anticipated and experienced discomfort rating for DL, 47 and 48 (0-100), were significantly higher (p < 0.01) than the anticipated and experienced discomfort of mammogram (38 and 34), MRI (36 and 25) or nipple aspiration (42 and 27). Women with greater pre-existing emotional distress experienced more DL-related discomfort than they anticipated. Women reporting DL-related pain as worse than expected were nearly three times more likely to refuse subsequent DL than those reporting it as the same or better than expected. Twenty-five percent of participants refused repeat DL at first annual follow-up.
DL was anticipated to be and experienced as more uncomfortable than other procedures used in breast cancer screening. Higher underlying psychological distress was associated with decreased DL tolerability.

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Available from: June A. Peters
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    • "DL, despite its invasiveness, produces material that is much more cellular than NAF that allows duct specific sampling. This method of obtaining breast ductal epithelial cells can be quickly performed in an office setting; patients do not need to be referred to a specialist and can potentially have the procedure by trained non-physician staff [16,17]. "
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