So what happens if you find you have atypical breast cells? If you are in the high risk category, there are several steps you can take. Continuous and vigilant monitoring of your breast cells, hormonal therapy (such as Tamoxifen)and repeat ductal lavage are a few of the choices. Some women are so fearful of developing breast cancer that they opt to undergo a prophylactic mastectomy, rather than face the possibility of cancer down the road. All decisions regarding your health are difficult.
Who should undergo ductal lavage? Women who are at "high risk", which includes the following factors: personal history of breast cancer, close relative with history of cancer (mom, sister, daughter), known BRCA1/BRCA2 mutation (genetic change), Gail index of 1.7+ (This is a model for assessing breast cancer risk).
What is involved with ductal lavage? First, an anesthetic cream is applied to the nipple area. This will numb it. A small suction device will be applied to the milk duct to draw fluid to the nipple surface. These drops of fluid help locate the milk duct opening on the nipple. Then a small catheter (tiny tube) is inserted into the nipple with anesthetic, to numb the duct itself. Then saline is inserted slowly to wash out the duct and collect the sample. The sample is then sent to the laboratory to check the cells.
Women who have undergone this procedure state that it is not any more uncomfortable than a mammogram and several friends have said it is much easier to tolerate. (I am waiting for it to be available in my area). I continually haunt my breast surgeon with my opinion that he should introduce this diagnostic tool to his practice. Since we have limited diagnostic tools (such as clinical breast exam, mammography and sonogram), this new and exciting procedure may help us to learn more about breast cancer and be able to predict those women who truly are at risk.
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