Patient and duct selection for nipple duct lavage

April Johnson Maddux, Raheela Ashfaq, Elizabeth Naftalis, Ann Marilyn Leitch, Susan Hoover, David Euhus

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Nipple ductal lavage (NDL) is a new minimally invasive procedure with the potential to help identify women who could benefit from breast cancer risk intervention. NDL is currently encouraged for women with fluid-producing ducts and a 5-year Gail risk ≥1.7%. The purpose of this study was to evaluate the atypia rate by NDL in fluid-producing ducts compared with nonfluid-producing ducts and the atypia rate in high-risk verses low-risk patients to determine if current recommendations are supported. Fifty-nine women were studied with NDL. The 226 ducts lavaged included all fluid-producing ducts (n = 136) and any dry ducts we could cannulate (n = 90). Breast cancer risk was calculated using mathematic models. There were 26 (44%) women with a 5-year Gail risk ≥1.7% and 33 (56%) with a 5-year Gail risk <1.7%. Cytologic atypia was diagnosed in 20 of 59 (34%) of patients. The atypia rate was similar for women with a 5-year Gail risk ≥1.7% (9 of 26 or 35%) compared with lower-risk women (11 of 33 or 33%, P = 1.0) and for fluid-producing ducts (26 of 136 or 19%) compared with dry ducts (14 of 90 or 15%, P = 0.61). No significant differences were found when the atypia was categorized as mild versus marked. Of note, the insufficient sample rate was higher for dry ducts (33%) compared with fluid-producing duct (22%, P = 0.07). If NDL results are found to correlate with breast cancer incidence, it will be important to apply the test in a way that maximizes sensitivity for the detection of atypia in a screened population. We were unable to identify patient or duct characteristics that predict NDL atypia rates.

Original languageEnglish (US)
Pages (from-to)390-394
Number of pages5
JournalAmerican Journal of Surgery
Volume188
Issue number4 SPEC. ISS.
DOIs
StatePublished - Oct 2004

Fingerprint

Nipples
Therapeutic Irrigation
Patient Selection
Breast Neoplasms
Mathematics
Incidence

Keywords

  • Atypia
  • Cancer risk
  • Nipple duct lavage

ASJC Scopus subject areas

  • Surgery

Cite this

Maddux, A. J., Ashfaq, R., Naftalis, E., Leitch, A. M., Hoover, S., & Euhus, D. (2004). Patient and duct selection for nipple duct lavage. American Journal of Surgery, 188(4 SPEC. ISS.), 390-394. https://doi.org/10.1016/j.amjsurg.2004.06.021

Patient and duct selection for nipple duct lavage. / Maddux, April Johnson; Ashfaq, Raheela; Naftalis, Elizabeth; Leitch, Ann Marilyn; Hoover, Susan; Euhus, David.

In: American Journal of Surgery, Vol. 188, No. 4 SPEC. ISS., 10.2004, p. 390-394.

Research output: Contribution to journalArticle

Maddux, AJ, Ashfaq, R, Naftalis, E, Leitch, AM, Hoover, S & Euhus, D 2004, 'Patient and duct selection for nipple duct lavage', American Journal of Surgery, vol. 188, no. 4 SPEC. ISS., pp. 390-394. https://doi.org/10.1016/j.amjsurg.2004.06.021
Maddux AJ, Ashfaq R, Naftalis E, Leitch AM, Hoover S, Euhus D. Patient and duct selection for nipple duct lavage. American Journal of Surgery. 2004 Oct;188(4 SPEC. ISS.):390-394. https://doi.org/10.1016/j.amjsurg.2004.06.021
Maddux, April Johnson ; Ashfaq, Raheela ; Naftalis, Elizabeth ; Leitch, Ann Marilyn ; Hoover, Susan ; Euhus, David. / Patient and duct selection for nipple duct lavage. In: American Journal of Surgery. 2004 ; Vol. 188, No. 4 SPEC. ISS. pp. 390-394.
@article{5ffe370ddd8642ee9bec295c533880e5,
title = "Patient and duct selection for nipple duct lavage",
abstract = "Nipple ductal lavage (NDL) is a new minimally invasive procedure with the potential to help identify women who could benefit from breast cancer risk intervention. NDL is currently encouraged for women with fluid-producing ducts and a 5-year Gail risk ≥1.7{\%}. The purpose of this study was to evaluate the atypia rate by NDL in fluid-producing ducts compared with nonfluid-producing ducts and the atypia rate in high-risk verses low-risk patients to determine if current recommendations are supported. Fifty-nine women were studied with NDL. The 226 ducts lavaged included all fluid-producing ducts (n = 136) and any dry ducts we could cannulate (n = 90). Breast cancer risk was calculated using mathematic models. There were 26 (44{\%}) women with a 5-year Gail risk ≥1.7{\%} and 33 (56{\%}) with a 5-year Gail risk <1.7{\%}. Cytologic atypia was diagnosed in 20 of 59 (34{\%}) of patients. The atypia rate was similar for women with a 5-year Gail risk ≥1.7{\%} (9 of 26 or 35{\%}) compared with lower-risk women (11 of 33 or 33{\%}, P = 1.0) and for fluid-producing ducts (26 of 136 or 19{\%}) compared with dry ducts (14 of 90 or 15{\%}, P = 0.61). No significant differences were found when the atypia was categorized as mild versus marked. Of note, the insufficient sample rate was higher for dry ducts (33{\%}) compared with fluid-producing duct (22{\%}, P = 0.07). If NDL results are found to correlate with breast cancer incidence, it will be important to apply the test in a way that maximizes sensitivity for the detection of atypia in a screened population. We were unable to identify patient or duct characteristics that predict NDL atypia rates.",
keywords = "Atypia, Cancer risk, Nipple duct lavage",
author = "Maddux, {April Johnson} and Raheela Ashfaq and Elizabeth Naftalis and Leitch, {Ann Marilyn} and Susan Hoover and David Euhus",
year = "2004",
month = "10",
doi = "10.1016/j.amjsurg.2004.06.021",
language = "English (US)",
volume = "188",
pages = "390--394",
journal = "American Journal of Surgery",
issn = "0002-9610",
publisher = "Elsevier Inc.",
number = "4 SPEC. ISS.",

}

TY - JOUR

T1 - Patient and duct selection for nipple duct lavage

AU - Maddux, April Johnson

AU - Ashfaq, Raheela

AU - Naftalis, Elizabeth

AU - Leitch, Ann Marilyn

AU - Hoover, Susan

AU - Euhus, David

PY - 2004/10

Y1 - 2004/10

N2 - Nipple ductal lavage (NDL) is a new minimally invasive procedure with the potential to help identify women who could benefit from breast cancer risk intervention. NDL is currently encouraged for women with fluid-producing ducts and a 5-year Gail risk ≥1.7%. The purpose of this study was to evaluate the atypia rate by NDL in fluid-producing ducts compared with nonfluid-producing ducts and the atypia rate in high-risk verses low-risk patients to determine if current recommendations are supported. Fifty-nine women were studied with NDL. The 226 ducts lavaged included all fluid-producing ducts (n = 136) and any dry ducts we could cannulate (n = 90). Breast cancer risk was calculated using mathematic models. There were 26 (44%) women with a 5-year Gail risk ≥1.7% and 33 (56%) with a 5-year Gail risk <1.7%. Cytologic atypia was diagnosed in 20 of 59 (34%) of patients. The atypia rate was similar for women with a 5-year Gail risk ≥1.7% (9 of 26 or 35%) compared with lower-risk women (11 of 33 or 33%, P = 1.0) and for fluid-producing ducts (26 of 136 or 19%) compared with dry ducts (14 of 90 or 15%, P = 0.61). No significant differences were found when the atypia was categorized as mild versus marked. Of note, the insufficient sample rate was higher for dry ducts (33%) compared with fluid-producing duct (22%, P = 0.07). If NDL results are found to correlate with breast cancer incidence, it will be important to apply the test in a way that maximizes sensitivity for the detection of atypia in a screened population. We were unable to identify patient or duct characteristics that predict NDL atypia rates.

AB - Nipple ductal lavage (NDL) is a new minimally invasive procedure with the potential to help identify women who could benefit from breast cancer risk intervention. NDL is currently encouraged for women with fluid-producing ducts and a 5-year Gail risk ≥1.7%. The purpose of this study was to evaluate the atypia rate by NDL in fluid-producing ducts compared with nonfluid-producing ducts and the atypia rate in high-risk verses low-risk patients to determine if current recommendations are supported. Fifty-nine women were studied with NDL. The 226 ducts lavaged included all fluid-producing ducts (n = 136) and any dry ducts we could cannulate (n = 90). Breast cancer risk was calculated using mathematic models. There were 26 (44%) women with a 5-year Gail risk ≥1.7% and 33 (56%) with a 5-year Gail risk <1.7%. Cytologic atypia was diagnosed in 20 of 59 (34%) of patients. The atypia rate was similar for women with a 5-year Gail risk ≥1.7% (9 of 26 or 35%) compared with lower-risk women (11 of 33 or 33%, P = 1.0) and for fluid-producing ducts (26 of 136 or 19%) compared with dry ducts (14 of 90 or 15%, P = 0.61). No significant differences were found when the atypia was categorized as mild versus marked. Of note, the insufficient sample rate was higher for dry ducts (33%) compared with fluid-producing duct (22%, P = 0.07). If NDL results are found to correlate with breast cancer incidence, it will be important to apply the test in a way that maximizes sensitivity for the detection of atypia in a screened population. We were unable to identify patient or duct characteristics that predict NDL atypia rates.

KW - Atypia

KW - Cancer risk

KW - Nipple duct lavage

UR - http://www.scopus.com/inward/record.url?scp=4944245575&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=4944245575&partnerID=8YFLogxK

U2 - 10.1016/j.amjsurg.2004.06.021

DO - 10.1016/j.amjsurg.2004.06.021

M3 - Article

C2 - 15474432

AN - SCOPUS:4944245575

VL - 188

SP - 390

EP - 394

JO - American Journal of Surgery

JF - American Journal of Surgery

SN - 0002-9610

IS - 4 SPEC. ISS.

ER -