Barnes-Jewish Hospital | Washington University Physicians
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New Test Improves Breast Cancer Diagnosis

Originally published Sep 2003

Doctors at the Siteman Cancer Center have a new test to help evaluate breast cancer in high-risk women.

When a lumpectomy determined Theresa Turner''s breast cancer was more advanced than doctors first believed, she was full of questions.  "Should I have a double mastectomy, should I have a single mastectomy, what am I dealing with here?" says Turner, "If they couldn''t see originally on the mammogram that this was going to be a bigger deal than just the lumpectomy, what am I dealing with here?"

To help fill in the gaps breast surgeon, Dr. Jill Dietz, suggested a new test that''s being done at the Siteman Cancer Center.  "Ductal Lavage has been around for a couple of years now, the idea of it has been around for decades," says Dr. Dietz, "Physicians have been trying to get information from the milk ducts because that is where the vast majority of breast cancer starts."

The procedure is done in the doctor''s office. It can take anywhere from 30 to 90 minutes depending on how many ducts are tested.  "Ductal Lavage is where we take a patient or a woman who is at high risk for developing breast cancer, but has a normal mammogram and a normal exam and we can put a very tiny catheter into the end of the natural opening of the nipple, after the nipple has been numbed lavage some fluid or salt water saline in there and then collect the cells that come out and put them under the microscope," says Dr. Deitz.

Doctors use a local anesthetic, so the procedure is relatively pain-free.  "I''ve been through so many of the tests at the breast health center really considering everything that I''ve been through the Ductal Lavage was definitely the least invasive, the least painful," says Turner.

"It was maybe just a little bit of discomfort, but it was really worth it to have the piece of mind, know that the other breast was clear," says Turner.

"It has to be understood that Ductal Lavage at this time is not a screening test; it is not to detect cancer," says Dr. Dietz, "The idea of Ductal Lavage is to take somebody who is already high risk, but the rest of their exams are normal and to find out more information about that women to help in decision making."

Women at high-risk include women with a family history of breast cancer, breast cancer survivors or women who''ve had previous biopsies showing high-risk lesions. "It''s not necessarily in there to find cancer early, although that can happen, it''s more about finding out who... it''s a risk stratification tool," says Dr. Dietz, "It finds out who is likely to develop cancer sooner and somebody who is not likely to develop cancer for a long time."

"They say that it gives you the earliest information so what didn''t show up on a mammogram or didn''t show up with the diagnostic testing could have shown up in that way and it didn''t," says Turner.

Theresa Turner would recommend the procedure to anyone who is diagnosed with breast cancer and wants all the information that''s possible. "I really feel like it did give me the information that I needed to make an informed decision it helped me to make a decision regarding my future and just my overall health," says Turner.

Doctors at the Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine are conducting a breast cancer study and looking for participants.

For Information:
Siteman Cancer Center
(314)362-2280


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