Obesity is associated with atypia in breast ductal lavage of women with proliferative breast disease.
BACKGROUND
Benign proliferative breast disease without atypia slightly increases breast cancer risk but there are currently few clinical options for breast cancer prevention in this group of women.


METHODS
We conducted a pilot study of women with a past diagnosis of proliferative breast disease with a goal to determine if the characteristics of cells obtained by breast ductal lavage were related to nutritional factors.


RESULTS
There were 57 women who enrolled. A total of 39 women yielded nipple aspirate fluid (NAF) samples and 36 underwent breast ductal lavage. Five of the lavage samples were acellular and 28 had at least 200 cells. Surprisingly, atypia was present in 11 women. Presence of atypia was associated with slight changes in morphometric features of the epithelial cells such as measures of circularity as obtained by image analysis, but the only variable significantly different in women with atypia (versus no atypia) was a higher mean body mass index. Body mass index was also significantly correlated with C-reactive protein (CRP) levels in the nipple aspirate fluid, indicating that obesity might have a pro-inflammatory effect on the breast that can contribute to increased rates of atypia.


CONCLUSIONS
Although the clinical significance of atypia in breast ductal lavage is uncertain, these results support further work on prevention of obesity as a strategy for reducing breast cancer risk.
Djuric
Zora
Z
Department of Family Medicine, University of Michigan, Ann Arbor, MI 48109, United States. zoralong@umich.edu
Edwards
Ann
A
Madan
Shashi
S
Darga
Linda
L
Ren
Jianwei
J
Blake
Cassann
C
Koletsky
Mathew
M
Heilbrun
Lance K
LK
D000328:Adult; D001826:Body Fluids / Q000737:chemistry; D015992:Body Mass Index; D001941:Breast Diseases / Q000473:pathology*; D001943:Breast Neoplasms / Q000209:etiology / Q000517:prevention & control*; D002097:C-Reactive Protein / Q000378:metabolism; D004847:Epithelial Cells / Q000473:pathology*; D005260:Female; D006801:Humans; D007249:Inflammation / Q000209:etiology / Q000473:pathology; D008875:Middle Aged; D009558:Nipples; D009765:Obesity / Q000150:complications*; D010865:Pilot Projects; D007507:Therapeutic Irrigation
D002097:C-Reactive Protein
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