More on ductal lavage

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Biomarkers on lavaged ductal cells identify malignant breast disease


NEW YORK (Reuters Health) - Quantitative analysis of biomarkers on cells obtained by breast ductal lavage is useful in distinguishing benign from malignant breast diseases, according to findings published in the July 15th issue of the International Journal of Cancer.

"Recent studies show that morphology-based analysis of ductal lavage specimens failed to detect many cancers in women with breast cancer," Dr. Jian-Yu Rao, at the University of California, Los Angeles, and colleagues write. "Such an observation raises doubts about the potential role of ductal lavage in an individual's risk assessment and early detection of breast cancer."

The researchers examined whether biomarker-based ductal lavage analysis is a useful method of risk assessment for breast cancer in a 2-phase study -- a training phase and a validation phase.

A total of 36 Chinese women (13 with breast cancer, 8 with intraductal papilloma, and 15 with benign breast diseases) were recruited for the training phase. Ten women with cancer and seven without cancer were recruited for the validation phase.

The ThinPrep technique was used to process lavage specimens. The samples were evaluated morphologically, and then by laser scan cytometry for two malignancy biomarkers -- so-called DNA 5c exceeding rate (DNA5cER), and G-actin level.

Biomarker analysis was performed on 24 of 36 (66.7%) samples in the training phase that had over 100 epithelial cells. The sensitivity of DNA5cER was 90%, with a specificity of 100%. The sensitivity of G-actin was 100%, with a specificity of 93%. Cytology alone resulted in a sensitivity and specificity of 66.7% and 93%, respectively.

Similar results were observed in the validation phase.

"The preliminary results suggest that a combination of ductal lavage and cellular biomarkers ... using the image-based quantitative fluorescence approach might circumvent the problems of cytology-based ductal lavage analysis," Dr. Rao's team concludes. "Clearly, additional studies with this approach will be needed to confirm the observation."

Int J Cancer 2006;119:359-364.