Ductal lavage and risk assessment of breast cancer

Following recent advances in breast cancer chemoprevention, much emphasis has been placed on risk assessment to evaluate whether women at increased risk for developing breast cancer should proceed with breast cancer risk reduction strategies. The currently available risk-reduction approaches include screening, chemoprevention, and preventive surgeries. Breast cancer arises from the epithelial linings of the ductal system, and it is believed that hyperplasia and atypical hyperplasia represent early changes in the breast carcinogenesis process. The ductal lavage procedure offers a minimally invasive method to obtain breast epithelial cells from the ductal system for cytopathologic analysis to provide individualized risk assessment. This paper reviews breast cancer risk factors, with an emphasis on cytological atypia and the role of ductal lavage in breast cancer risk assessment.