By identifying the microscopic cellular changes that occur inside the milk ducts, surgeons at Vanderbilt University are hoping to find a way to detect breast cancer very early in its development.
Researchers at the Vanderbilt-Ingram Cancer Center in Nashville are about to begin testing a new ductal lavage examination. The method involves identifying the ducts in the breast that produce fluid, and then washing them with a saline solution to obtain a cell sample, which is checked to determine if the cells are normal, atypical or malignant.
The team, made up of surgeons and pathologists, plan to enroll 20 women in the study, said Caroline Gilmore, a nurse at the Vanderbilt cancer center. A group from the company that developed the ductal lavage technique, Pro-Duct Health of Menlo Park, CA, will give a training session at Vanderbilt on February 17. Gilmore said two patients have enrolled, while about 30 others have expressed an interest in the study.
"We need patients who will consent to long-term follow-up," Gilmore said. "Say we get back a normal cytology. We’d like to know if, five or 10 years down the line, the woman will still develop cancer. We want to see how the cytology of doing this procedure will hold up."
What part radiologists will play in this study has yet to be determined, said a spokeswoman for Pro-Duct Health. However, all the women who are enrolled in the study must have undergone a mammogram in the past year and must have had a physical examination with normal results, Gilmore said.
The ductal lavage procedure will be done under local anesthetic, with the fluid-producing ducts identified using a modified breast pump. A fine catheter will be used, although a clinical spokeswoman for Pro-Duct declined to give specifics.
The concept is similar to the Pap smear for screening cervical cancer, said Dr. Mark Kelley, assistant professor of surgery and director of the Vanderbilt Breast Center.
One issue the team is still grappling with is what their course of action will be when a ductal lavage test shows abnormalities, Gilmore said. While the surgeons may be disposed to remove the duct and surrounding tissue, oncologists may prefer to follow the patient more closely or do a biopsy, she added.
Other test sites for this technique include medical centers at the University of California, Los Angeles, Yale University in New Haven, CT, and Beth Israel Medical Center in New York City.
By Shalmali Pal
AuntMinnie.com staff writer
February 10, 2000
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