Ductal lavage: A novel approach for breast cancer risk assessment: Why, how, and when

The ability to assess women for breast cancer risk is limited. The currently available approaches, such as the commonly used Gail Model, have significant limitations. The risk assessed is population-based and not based on specific cytology of the individual woman. Therefore, improved individualized methods for risk assessment are needed, particularly with the increasing use of prophylactic approaches to breast cancer, such as with the prophylactic use of tamoxifen. Ductal lavage is a recently developed technique for evaluating a woman's intraductal cytology based on "rinsing" the ducts with aliquots of saline and evaluating the resultant fluid cytopathologically. This manuscript describes the ductal lavage procedure, the data supporting cytologic evaluation of intraductal cells, and the clinical indications for ductal lavage as well as possible future uses.