Simple procedure could be performed in most doctors’ offices, experts say

A better breast cancer test? NBC's Robert Bazell reports.

Dec. 4 — Women with abnormal cells in their breast fluid face an increased of developing breast cancer, a major study released Tuesday found.

SANDI BUONO knows she faces a high risk of breast cancer because her mother had it. So she gets regular mammograms. But to protect herself even further, she is trying a new procedure that painlessly removes a few cells from inside her breast.

The technique is called ductal lavage. After applying an anesthetic cream the doctor inserts a tiny tube in the nipple, puts in some salt water and then removes loose cells with a device similar to a breast pump.

"It wasn’t uncomfortable. You did feel some sensations. Nothing that was painful," Buono said.

Doctors examine the cells under a microscope to see if any are precancerous.

"It gives us a window to look into a woman’s breast to see what’s going on in a biological sense. What are the cells actually like inside her breast?" said Dr. Robert Gardiner of the Columbia Hospital Center for Breast Care.

In a study appearing in the Journal of the National Cancer Institute, researchers classified 7,600 woman by the types of cells found in their breast fluids drawn using a no-needle technique — a modified manual breast pump that mimics the suction force of a nursing infant. After following the women for an average of 14 years, they found that women whose breast fluid contained abnormal cells were two to three times as likely to develop breast cancer later in life than women from whom no fluid could be obtained. Women with normal cells in the fluid had about a 30 percent greater risk of breast cancer, compared with those with no fluid.

The study’s lead author, Dr. Margaret Wrensch, an epidemiologist at the University of California, San Francisco, School of Medicine said that study suggests, but does not prove, that for a woman who is not pregnant or nursing, production of any fluid at all may be an indication of increased risk. She said the fluid could signal that there are changes underway in the breast.

The investigators said the procedures should help determine exactly which women need drugs like tamoxifien to lower their risk of developing the disease.

"Our main goal in breast cancer research is to try and short-circuit the disease process before women actually develop breast cancer. In order to do that we need to identify women who are at very high risk of breast cancer," Wrensch said. Many doctors are optimistic that breast-fluid tests can help do that.

For now, insurance often does not pay the up to $1,800 cost of ductal lavage because it is still in the experimental stages, but several trials are underway to prove just how useful it can be.

Experts say mammography will remain the gold standard for breast cancer detection, but they hope breast-fluid tests could someday help millions to avoid cancer in the first place.