Detection of chromosomal aneusomy by fluorescence in situ hybridization for patients with nipple discharge.
BACKGROUND
Breast carcinoma and precancer are believed to start in the lining of the milk duct or lobule. Ductography and fiberoptic ductoscopy (FDS) are used to identify abnormal intraductal lesions, although it is difficult to distinguish malignant from benign cases. Therefore, we studied the clinical usefulness of fluorescence in situ hybridization (FISH) analysis of a numerical aberration of chromosomes (aneusomy) using ductal lavage from patients with nipple discharge.


METHODS
We applied ductography and FDS to 90 women who had nipple discharge. Ductal lavages obtained from patients with positive ductography and/or FDS findings were subjected to cytology and FISH analysis using centromere probes for chromosomes 1, 11, and 17. Patients with samples that showed aneusomy in at least one of the three chromosomes were diagnosed as positive.


RESULTS
Histologic evaluation revealed 54 benign lesions and six malignancies. The sensitivity, specificity, and diagnostic accuracy were 33.3%, 88.9%, and 83.3%, respectively, for cytology and 100%, 100%, and 100%, respectively, for FISH.


CONCLUSIONS
The results demonstrated that FISH has a diagnostic accuracy comparable to cytology. This technique has 100% specificity is making a definitive diagnosis of malignancy in patients with indeterminate cytologic results, suggesting that FISH diagnosis can be a good adjunct to cytology.
Yamamoto
Daigo
D
Department of Surgery, Kansai Medical University, Osaka, Japan. yamamotd@takii.kmu.ac.jp
Senzaki
Hideto
H
Nakagawa
Hiroyuki
H
Okugawa
Homa
H
Gondo
Hideki
H
Tanaka
Kanji
K
D000328:Adult; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D002869:Chromosome Aberrations; D002878:Chromosomes, Human, Pair 1; D002880:Chromosomes, Human, Pair 11; D002886:Chromosomes, Human, Pair 17; D003581:Cytodiagnosis / Q000379:methods*; D004724:Endoscopy; D005260:Female; D006801:Humans; D017404:In Situ Hybridization, Fluorescence; D008875:Middle Aged; D009558:Nipples / Q000378:metabolism*; D011859:Radiography; D012680:Sensitivity and Specificity; D007507:Therapeutic Irrigation