Ductal lavage: what we know and what we don't

Ductal lavage is a procedure that can improve the stratification of women with clinical evidence of increased breast cancer risk by the cytologic detection of atypia. The relative risk of future breast cancer in women harboring atypia is approximately 3 to 5, as demonstrated in studies of women harboring atypia within direct nipple aspirates, fine-needle aspiration biopsies, and histopathology from surgical specimens. It is intuitively reasonable and biologically plausible that atypia detected in ductal lavage specimens would be associated with a comparable measure of association; however, documentation of this assumption awaits maturation of prospectively accumulated data. The technology of the ductal lavage procedure is also a promising translational research tool, because of the relatively substantial yield of ductal cellular material for analysis via a minimally invasive technique.