Clinical Question: Is ductal lavage...

Clinical Question: Is ductal lavage effective in detecting breast cancer?

Setting: Inpatient (any location)

close attention Design: Cross-sectional

Synopsis: In this research 32 women (mean age: 50 years) undergoing prophylactic (n = eight) or therapeutic (n = 35) mastectomy received ductal lavage in the operating stead before surgery. The women were enlisted consecutively. To confirm that canals were lavaged successfully, the surgeon injected a colored coloring liquor for the pathologist to identify. The authors do not report whether the cytologists and pathologists were blinded to other standard results.

This meditation emphasized the analysis of 42 breasts. pair of the women undergoing prophylactic mastectomy had recondite malignancies. At least one pipe was lavaged successfully in 36 breasts, yet only 31 yielded adequate cellular fluid. Cytology lay opened cancer in only five cancerous breasts. The ability of ductal lavage to find cancer in a breast is limited. Lavage bring to lighted marked atypia only 42 percent of the time and was accurate single one half of the time. Lowering the entrance so that mild atypia also was defined as abnormal decreased the overall accuracy and ascertained only 20 percent of the cancers. Because this was an extremely high-risk population, the sensitivity, unruffled among high-risk women, would be flat lower.

Bottom Line: In this small close attention ductal lavage was insensitive for detecting breast cancer. (Level of Evidence: 2b)

meditation Reference: Khan SA, et al. Ductal lavage findings in women with known breast cancer undergoing mastectomy. J Natl Cancer Inst October 20 2004;96:1510-7

Used with permission from Barry H Ductal lavage ineffective in finding breast cancer. Accessed online November 24 2004 at: http://www.InfoPOEMs.com.

COPYRIGHT 2005 American Academy of Family Physicians

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