title: The feasibility of nipple aspiration and duct lavage to evaluate the breast duct epithelium of women with increased breast cancer risk.
abstract: OBJECTIVE
  Nipple aspiration (NA) and duct lavage (DL) are modalities for obtaining breast duct fluid for biomarker analyses. The aim of this study was to assess the feasibility of obtaining serial NA and DL samples at consecutive patient visits for cytology assessment and the creation of a biobank.
  
  
  METHODS
  Seventy eligible subjects were enroled at a single institution in the United Kingdom as part of an international multicentre study. Entry criteria were based on a 5-year Gail model risk of ≥2% or Claus score lifetime risk of ≥26%. Women underwent NA and DL in an outpatient clinic under local anaesthesia.
  
  
  RESULTS
  The mean patient age was 48 (range 41-69)years. Sixty seven out of 70 women (96%) attended three consecutive 6 monthly visits and follow-up for 2 years. Three women withdrew due to intolerance of the DL procedure. 56/67 (83%) women produced NA fluid from at least one duct. 204/264 (77%) of ducts declared by NA were cannulated for DL. 170/204 (83%) produced DL samples with adequate cellularity. By the final visit 52/67 (78%) women produced DL, 28/52 (54%) of whom were premenopausal and 24/52 (46%) were postmenopausal. 50/52 women (96%) underwent repeated DL of 81 ducts on 3 consecutive visits.
  
  
  CONCLUSIONS
  NA and DL are well tolerated for repeated assessment to obtain material for cytology and to create a biobank for future biomarker studies in women at high breast cancer risk.
authors.affiliation: Academic Surgery (Breast Unit), Royal Marsden NHS Trust, London, UK.
authors.forename: Dominique
authors.initials: D
authors.lastname: Twelves
authors.forename: Ashutosh
authors.initials: A
authors.lastname: Nerurkar
authors.forename: Peter
authors.initials: P
authors.lastname: Osin
authors.forename: Ann
authors.initials: A
authors.lastname: Ward
authors.forename: Clare M
authors.initials: CM
authors.lastname: Isacke
authors.forename: Gerald P H
authors.initials: GP
authors.lastname: Gui
mesh_terms: D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000032:analysis; D001826:Body Fluids / Q000166:cytology; D001943:Breast Neoplasms / Q000175:diagnosis*; D003581:Cytodiagnosis / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D042361:Mammary Glands, Human / Q000166:cytology*; D008875:Middle Aged; D009558:Nipples / Q000166:cytology*; D012307:Risk Factors; D013396:Suction; D007507:Therapeutic Irrigation
chemical_list: D014408:Biomarkers, Tumor