Feasibility of breast duct lavage performed by a physician extender. Surgery 2004 Nov;136(5):1077-80; discussion 1080-2
Date
11/04/2004Pubmed ID
15523404DOI
10.1016/j.surg.2004.08.004Scopus ID
2-s2.0-7544241944 (requires institutional sign-in at Scopus site) 3 CitationsAbstract
BACKGROUND: The safety and feasibility of ductal lavage (DL), a risk-assessment tool utilizing a minimally invasive technique that permits sampling of breast duct epithelium, performed primarily by a nurse practitioner (NP), was studied prospectively.
METHODS: Women at high risk for breast cancer with a normal clinical breast exam and mammogram were enrolled. Nipple aspirate fluid (NAF)-yielding ducts were identified, cannulated, and lavaged primarily by an NP in collaboration with a breast surgeon. Samples with sufficient cellularity were categorized as benign, mild atypia, marked atypia, or malignant. Pain and adverse events were recorded.
RESULTS: Thirty-seven women, with a mean age of 51.7 years, were enrolled. Thirty-one (83.8%) women yielded NAF and, of those, 28 (90.3%) had one or more ducts successfully cannulated. Of 65 lavaged ducts in these 28 women, cellularity was adequate for diagnosis in 44 (67.7%) samples. Cytologic findings were as follows: 24 benign, 15 mild atypia, 4 marked atypia, and 1 malignant. The procedure was well tolerated with a mean pain score of 3.2 (SD +/- 1.81). The most frequent adverse event was breast fullness, reported by 44.8% of the women. Two women with marked atypia were evaluated further and found to have intraductal papillomata. The woman with malignant cytology had ductal carcinoma in situ.
CONCLUSION: DL is a safe, generally well-tolerated procedure that can be performed successfully by a trained NP.
Author List
Redlich PN, Purdy AC, Shidham VB, Yun HJ, Walker A, Ota DAuthors
Anna C. Purdy APP Outpatient in the Surgery department at Medical College of WisconsinPhilip N. Redlich PhD, MD Professor in the Surgery department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
Body FluidsFeasibility Studies
Female
Genes, BRCA1
Genes, BRCA2
Humans
Middle Aged
Nipples
Nurse Practitioners
Patient Satisfaction
Therapeutic Irrigation
