Detection of chromosomal instability in paired breast surgery and ductal lavage specimens by interphase fluorescence in situ hybridization.
OBJECTIVE
Ductal lavage is a new modality for collecting exfoliated breast cells with the goal of detecting early neoplasia. The purpose of our study was to evaluate the correlation between cancer-associated abnormalities in breast lesions and exfoliated breast cells collected by ductal lavage.


METHODS
We performed histopathologic, cytologic, and molecular cytogenetic analyses on 39 paired cases of surgically excised breast lesions and ductal lavage specimens collected immediately before surgery.


RESULTS
Abnormal cytology was detected in 7 of 15 (47%) of the evaluable lavages collected from malignant cases, versus 4 of 19 (21%) of the evaluable lavages harvested from benign cases for a sensitivity and specificity of 47 and 79%, respectively. Interphase fluorescence in situ hybridization analysis of all evaluable lavages revealed numeric changes on chromosomes 1, 8, 11, and/or 17 in 10 of 14 (71%) specimens from malignant cases versus 2 of 18 (11%) from benign cases for a sensitivity and specificity of 71 and 89%, respectively.


CONCLUSIONS
Our study demonstrates that cytologic and genetic abnormalities associated with breast cancer progression can be detected in ductal lavage cells collected from women with in situ and invasive breast cancer and suggests that fluorescence in situ hybridization may have superior sensitivity and specificity compared with conventional cytology.
King
Bonnie L
BL
Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, Connecticut 06520, USA. bonnie.king@yale.edu
Tsai
Steven C
SC
Gryga
Michele E
ME
D'Aquila
Thomas G
TG
Seelig
Steven A
SA
Morrison
Larry E
LE
Jacobson
Kris K B
KK
Legator
Mona S
MS
Ward
David C
DC
Rimm
David L
DL
Phillips
Rogsbert F
RF
D001940:Breast / Q000378:metabolism; D001943:Breast Neoplasms / Q000378:metabolism* / Q000401:mortality / Q000601:surgery*; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000378:metabolism* / Q000401:mortality / Q000601:surgery*; D002869:Chromosome Aberrations; D018450:Disease Progression; D005260:Female; D006801:Humans; D017404:In Situ Hybridization, Fluorescence / Q000379:methods*; D009361:Neoplasm Invasiveness; D007507:Therapeutic Irrigation