Q. I recently read an article in a magazine about ductal lavage test. Is this test available through Providence?
Answer from the expert staff of breast cancer research at the Robert W. Franz Cancer Research Center at Providence Portland Medical Center: The value of the ductal lavage test is still being debated. Ductal lavage is not widely available. It is not available at Providence, or anywhere in Oregon.
Ductal lavage is a minor surgical procedure in which cells from the breast's milk ducts are obtained from the nipple and tested to see if they are normal, atypical or possibly precancerous, or malignant. Ductal lavage is unproven, but the hope is that it can reliably find suspicious or cancerous breast cells at the earliest possible time, which would hopefully lead to increased opportunities for effective treatment and decreased breast cancer mortality. One problem is that we can already find suspicious and atypical cells with breast biopsy but do not know yet how to accurately predict which women with these types of cells will get breast cancer or what the best treatment for them is.
The practitioners who provide ductal lavage recommend it only be performed on women who are considered to have a high risk for developing breast cancer. Breast cancer risk is determined by assessing a women's health history, family history, and reproductive history.
The Providence Cancer Risk Assessment Program offers free risk assessment to people concerned about their cancer risk. To contact the risk assessment program, call: (503) 215-3175.
Currently we do not know enough about the benefits of ductal lavage to encourage women to have it. For example, we do not know which women who are found to have atypical or suspicious cells with ductal lavage will go on to develop breast cancer.
The presence of atypical cells on breast biopsy increases a women's risk for developing breast cancer, but not all women with atypical cells go on to develop breast cancer. Conversely, we cannot guarantee that a woman with normal cells on ductal lavage will not later develop breast cancer.
A potential benefit is that the results of their ductal lavage may help women who are considering breast cancer risk reduction strategies (tamoxifen or prophylactic surgery) with their decisions.
It is important to understand that the result of a ductal lavage does not change a woman's breast cancer risk. Women who are considered to be at high risk for breast cancer and have a normal ductal lavage result will still be considered to be at high risk for developing breast cancer during their lives, and their risk reduction options are the same with or without ductal lavage.
There is no guaranteed way to prevent breast cancer. Risk reduction methods include tamoxifen and prophylactic surgery, and increased surveillance is used to promote early detection. It is also important to know that ductal lavage does not replace current breast cancer screening recommendations. Women who undergo ductal lavage are still recommended to perform monthly breast self-exam, and have clinical breast exams and mammograms as recommended by their physicians.
There are clinical trials underway investigating whether ductal lavage is a useful method to detect breast cancer early and promote more effective treatment.
For more information:
  Browse our experts' answers to reader questions on other health topics.
Last updated: June 2003
|
