Skip to main content
Log in

Failure of High Risk Women to Produce Nipple Aspirate Fluid Does Not Exclude Detection of Cytologic Atypia in Random Periareolar Fine Needle Aspiration Specimens

  • Published:
Breast Cancer Research and Treatment Aims and scope Submit manuscript

Abstract

Introduction. Evidence of hyperplasia with atypia found both on random periareolar fine needle aspiration (RPFNA) and in nipple aspirate fluid (NAF) fluid are associated with an increased risk for breast cancer.

Aim. In this study, we report the correlation of NAF production with cytological assessment of ductal cells obtained by RPFNA.

Methods. 113 women at high risk for development of breast cancer attending the Breast Cancer Prevention Clinic at the University of Kansas Medical Center underwent a single NAF collection attempt and RPFNA.

Results. NAF was successfully collected in 51% of women. There was no significant difference in age, 5-year Gail risk assessment, menopausal status, hormone use, family history of breast cancer, history of prior atypical hyperplasia/LCIS or history of contralateral DCIS/invasive breast cancer between women who produced NAF and those that did not. The only significant difference between the two groups was in history of prior lactation (p= 0.018). Twenty-seven of the 113 subjects were found to have hyperplasia with atypia by RPFNA was 31% in women who produced NAF versus 16% in those who did not (p= 0.07).

Conclusion. Although prevalence of RPFNA atypia was numerically higher in NAF producers than non-producers the difference did not reach statistical significance. Failure to produce NAF does not exclude the presence of hyperplasia with atypia by random periareolar fine needle aspiration.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Page DL, Dupont WD: Anatomic markers of human premalignancy and risk of breast cancer. Cancer 66: 1326–1335, 1990

    PubMed  Google Scholar 

  2. Boone CW, Kelloff GJ: Intraepithelial neoplasia, surrogate endpoint biomarkers, and cancer chemoprevention. J Cell Biochem Suppl 17F: 37–48, 1993

    Article  PubMed  Google Scholar 

  3. Tavassoli FA, Norris HJ: A comparison of the results of long term follow up for atypical intraductal hyperplasia and intraductal hyperplasia of the breast. Breast J 1: 155–162, 1995

    Google Scholar 

  4. Marshall LH, Hunter DJ, Connolly JL, Schnitt SJ, Byrne C, London SJ, et al. Risk of breast cancer associated with atypical hyperplasia of lobular and ductal types. Cancer Epidemiol Biomarkers Prev 6: 297–301, 1997

    PubMed  Google Scholar 

  5. Fabian CJ, Kimler BF, Elledge RM, Grizzle WE, Beenken SW, Ward JH: Models for early chemoprevention trials in breast cancer. Hematol Oncol Clin North Am 12: 993–1017, 1998

    Article  PubMed  Google Scholar 

  6. Morrow M, Vogel V, Ljung BM, O 'Shaughnessy JA: Evaluation and management of the woman with an abnormal ductal lavage. J Am College Surg 194: 648–656, 2002

    Article  Google Scholar 

  7. Khan S, Baird C, Morrow M: Ductal lavage and Ductoscopy: the opportunities and the limitations. Clin Breast cancer 3: 185–191, 2002

    PubMed  Google Scholar 

  8. O 'Shaughnessy JA, Ljung BM, Dooley WC, Chang J, Kuerer HM, Hung DT, Grant MD, Khan SA, Phillips RF, Duvall K, Euhus DM, King BL, Anderson BO, Troyan SL, Kim J, Veronesi U, Cazzaniga M: Ductal lavage and the clinical management of women at high risk for breast carcinoma: a commentary. Cancer 94: 292–298, 2002

    Article  PubMed  Google Scholar 

  9. Fabian CJ, Kimler BF: Breast cancer chemoprevention: current challenges and a look towards the future. Clin Breast Cancer 3: 113–124, 2002

    PubMed  Google Scholar 

  10. Fabian CJ, Kimler BF, Zalles CM, Klemp JR, Kamel S, Zeiger S, Mayo MS: Short-term breast cancer prediction by random periareolar ne-needle aspiration cytology and the Gail risk model. J Natl Cancer Inst 92: 1217–1227, 2000

    Article  PubMed  Google Scholar 

  11. Dooley WC, Ljung BM, Veronesi U, Cazzaniga M, Elledge RM, O 'Shaughnessy JA, Kuerer HM, Hung DT, Khan SA, Phillips RF, Ganz PA, Euhus DM, Esserman LJ, Haffty BG, King BL, Kelley MC, Anderson MM, Schmit PJ, Clark RR, Kass FC, Anderson BO, Troyan SL, Arias RD, Quiring JN, Love SM, Page DL, King EB: Ductal lavage for detection of cellular atypia in women at high risk for breast cancer. J Natl Cancer Inst 93: 1624–1632, 2001

    PubMed  Google Scholar 

  12. Wrensch MR, Petrakis NL, Miike R, King EB, Chew K, Neuhaus J, Lee MM, Rhys M: Breast cancer risk in women with abnormal cytology in nipple aspirates of beast fluid. J Natl Cancer Inst 93: 1791–1798, 2001

    Article  PubMed  Google Scholar 

  13. Klein P, Glaser E, Grogan L, Kirsch I: Biomarker assay in nipple aspirate fluid. The Breast J 7: 378–387, 2001

    Article  Google Scholar 

  14. Gann P, Chatterton R, Vogelsong K, Ellman A: Mitogenic growth factors in breast fluid obtained from healthy women: evaluation of biological and extraneous sources of viability. Cancer Epidemiol Biomarkers Prevention 6: 421–428, 1997

    Google Scholar 

  15. Harding C, Osundeko O, Tetlow I, Bundred NJ: Hormonally regulated proteins in breast secretions are markers of target organ sensitivity. Br J Cancer 82: 354–360, 2000

    Article  PubMed  Google Scholar 

  16. Sauter ER, Ross E, Daly M, Klein-Szanto A, Engstrom PF, Sorling A, Malick J, Ehya H: Nipple aspirate fluid: a promising non-invasive method to identify cellular markers of breast cancer risk. Br J Cancer 76: 494–501, 1997

    PubMed  Google Scholar 

  17. Wrensch MR, Petrakis NL, Gruenke LD, Ernster VL, Miike R, King EB, Hauck WW: Factors associated with obtaining nipple aspirate fluid: analysis of 1428 women and literature review. Breast Cancer Res Treat 15: 39–51, 1990

    Article  PubMed  Google Scholar 

  18. Gail MH, Brinton LA, Byar DP, Corle DK, Green SB, Schairer C, Mulvihill JJ: Projecting individualized probabilities of developing breast cancer for white females who are being examined annually. J Natl Cancer Inst 81: 1879–1886, 1989

    PubMed  Google Scholar 

  19. Gail MH, Costantino JP, Bryant J, Croyle R, Freedman L, Helzlsouer K, Vogel V: Weighing the risks and benefits of tamoxifen treatment for preventing breast cancer. J Natl Cancer Inst 91: 1829–1846, 1999

    Article  PubMed  Google Scholar 

  20. Zalles C, Kimler BF, Kamel S, McKittrick R, Fabian CJ: Cytologic patterns in random aspirates from women at high and low risk for breast cancer. The Breast J 1: 343–349, 1995

    Google Scholar 

  21. Masood S, Frykberg ER, McLellan GL, Scalapino MC, Mitchum DG, Bullard JB: Prospective evaluation of radiologically directed ne-needle aspiration biopsy of nonpalpable breast lesions. Cancer 66: 1480–1487, 1990

    PubMed  Google Scholar 

  22. Masood S: Cytomorphology of brocystic change, high risk, and premalignant breast lesions. Breast J 1: 210–221, 1995

    Google Scholar 

  23. The uniform approach to breast ne-needle aspiration biopsy. National Cancer Institute Fine-Needle Aspiration of Breast Workshop Subcommittees. Diagn Cytopathol 16: 295–311, 1997

    Google Scholar 

  24. Wrensch M, Petrakis NL, King EB, Lee MM, Miike R: Breast cancer risk associated with abnormal cytology in nipple aspirates of breast fluid and prior history of breast biopsy. Am J Epidemiol 137: 829–833, 1993

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Sharma, P., Klemp, J.R., Simonsen, M. et al. Failure of High Risk Women to Produce Nipple Aspirate Fluid Does Not Exclude Detection of Cytologic Atypia in Random Periareolar Fine Needle Aspiration Specimens. Breast Cancer Res Treat 87, 59–64 (2004). https://doi.org/10.1023/B:BREA.0000041582.11586.d3

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/B:BREA.0000041582.11586.d3

Navigation