title: Does ductal lavage assert its role as a noninvasive diagnostic modality to identify women at low risk of breast cancer development?
abstract: OBJECTIVE
  Ductal lavage (DL) involves evaluation of the ductal system of the breast for detection of intra-ductal carcinomas and precursor lesions by collecting breast epithelial cells using a small-gauge catheter inserted into a ductal orifice on the nipple. The aim of this survey was to analyze cytologic features of samples obtained from low-risk women with DL and to elucidate the efficacy of this diagnostic modality in evaluating fluid production, cannulating and determining atypical breast epithelial cells.
  
  
  METHODS
  Into this prospective study were consecutively registered 80 women between ages 28 to 67. Nipple aspiration was performed to identify all fluid-yielding ducts. According to the grading of specific features the interpretation of the sample included: normal/benign (category, 0), mild atypical (category, I), markedly atypical (category, II) or malignant (category, III) disorders.
  
  
  RESULTS
  Ninety five percent (316/334) of the nipple aspirate fluid samples were classified as category 0, 4.8% (16/334) as category I and 0.2% (2/334) as category II changes. Category III disorders were not detected. Therefore, in 80% of the women examined results were within normal limits while 17.5% of the participants presented mild atypical and 2.5% markedly atypical rates.
  
  
  CONCLUSIONS
  DL collection procedure proved to be rapid as well as acceptable by the women studied. It retains the advantage over other methods of nipple aspirate fluid in that it is easy to perform, thereby removing most clinician variability. It also helped low risk women to discriminate those with breast disorders that require additional investigation, further follow-up or administration of preventive medication.
authors.affiliation: 4th Department of Surgery, Attikon University Hospital, Athens University Medical School, Athens, Greece.
authors.forename: Ioanna
authors.initials: I
authors.lastname: Konstandiadou
authors.forename: Aikaterini
authors.initials: A
authors.lastname: Mastoraki
authors.forename: Olympia
authors.initials: O
authors.lastname: Kotsilianou
authors.forename: Petros
authors.initials: P
authors.lastname: Karakitsos
authors.forename: George
authors.initials: G
authors.lastname: Athanasas
authors.forename: Vasilios
authors.initials: V
authors.lastname: Smyrniotis
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Arkadopoulos