title: Does the new automated "HALO" nipple aspiration fluid system really deliver as promised? The answer is "No, but...": A literature review of the role of breast fluid cytology in cancer risk assessment.
abstract: The HALO breast Pap test is a new automated nipple aspiration fluid (NAF) system that was recently introduced into the market. In an extensive marketing campaign directed principally toward OB/GYN practices, including endorsements from few local news media, HALO has been promoted as the "new Pap screening test for breast." Physicians are encouraged to perform this test on all women, as part of their annual examination, with claims that HALO will detect breast cancers as early as 10 years before mammography. These arguments are made more appealing to physician's offices by highlighting the potential positive financial impact on their practices, without consuming physician time, as medical assistants or technicians can perform this test. As a result of this directed campaign, cytology laboratories are increasingly confronted with implementing the HALO system and clinicians are increasingly soliciting pathologist's input regarding its validity. Yet, there is no data available regarding this new system, outside rare reports sponsored by the manufacturer. In this discussion, I examine the pros and cons of this new NAF system, including literature review of breast fluid cytology, and how it relates to breast cancer risk assessment.
authors.affiliation: Ball Memorial Hospital, PA Labs, Muncie, Indiana, USA. elsheikht@palab.com
authors.forename: Tarik M
authors.initials: TM
authors.lastname: Elsheikh
mesh_terms: D001826:Body Fluids / Q000166:cytology*; D001943:Breast Neoplasms / Q000175:diagnosis*; D003584:Cytological Techniques; D055088:Early Detection of Cancer; D005260:Female; D006801:Humans; D009558:Nipples / Q000473:pathology*; D012307:Risk Factors