Cytologic findings and protein expression profiles associated with ductal carcinoma of the breast in ductal lavage specimens using surface-enhanced laser desorption and ionization-time of flight mass spectrometry.
BACKGROUND
Early detection of breast carcinoma enhances the chances for patient survival. The authors' work focused on an innovative technique that couples breast ductal lavage (DL) with surface-enhanced laser desorption and ionization-time of flight mass spectrometry (SELDI-TOF MS) to yield a highly sensitive and specific method of breast carcinoma detection.


METHODS
The study group included 16 women who had unilateral, biopsy-proven breast carcinoma. Studying paired DL specimens from each woman (the breast with and the breast without carcinoma), a cytologic investigation was performed on the cells present in the DL samples, and the protein content of the DL fluid was analyzed with the SELDI-TOF MS technique using the strong anionic exchange chip surface.


RESULTS
Only 5 of 16 DL specimens (31%) from breasts with biopsy-proven carcinoma contained malignant cells, whereas the remaining samples contained only histiocytes and clusters of benign ductal epithelium. In contrast, 12 of 16 DL specimens (75%) from breasts that contained carcinoma had a different protein peak pattern compared with the paired DL specimen from the same patient's contralateral, uninvolved breast. This finding was independent of the presence of neoplastic cells in the lavage fluid. In addition, specific protein peaks, which may represent potential biomarkers, were identified in the DL fluids from breasts with carcinoma. Some of these peaks were conserved between different patients.


CONCLUSIONS
The combination of breast DL with SELDI-TOF MS offers a unique and powerful technique for the detection and monitoring of breast carcinoma. This method has the potential to enhance the diagnostic utility of conventional DL cytology.
Mendrinos
Savvas
S
Department of Pathology and Laboratory Medicine, Emory University, Atlanta, Georgia 30322, USA.
Nolen
John David L
JD
Styblo
Toncred
T
Carlson
Grant
G
Pohl
Jan
J
Lewis
Melinda
M
Ritchie
James
J
D019313:BRCA1 Protein / Q000032:analysis; D024682:BRCA2 Protein / Q000032:analysis; D014408:Biomarkers, Tumor / Q000032:analysis; D044963:Biopsy, Fine-Needle; D001943:Breast Neoplasms / Q000473:pathology*; D044584:Carcinoma, Ductal / Q000473:pathology*; D016022:Case-Control Studies; D003581:Cytodiagnosis / Q000379:methods; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D009363:Neoplasm Proteins / Q000032:analysis*; D009558:Nipples / Q000166:cytology; D012494:Sampling Studies; D012680:Sensitivity and Specificity; D019032:Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization / Q000379:methods*; D046509:Tissue Culture Techniques
D019313:BRCA1 Protein; D024682:BRCA2 Protein; D014408:Biomarkers, Tumor; D009363:Neoplasm Proteins