Skip to main content

Breast Cancer Risk in Women with Abnormal Cytology in Nipple Aspirate Fluid

  • Chapter
Methods of Cancer Diagnosis, Therapy and Prognosis

Part of the book series: Methods of Cancer Diagnosis, Therapy and Prognosis ((HAYAT,volume 1))

  • 2094 Accesses

Fear of developing breast cancer is well-founded among women. Breast cancer is the leading cause of death among women ages 20–59 years of age, and the second-leading cause of death in women over 50 years of age (Jemal et al., 2005). Approximately 40,000 women will die of this disease in the United States this year. Refining the science of breast cancer risk assessment has become more important with the development of medications to reduce breast cancer risk, the addition of expensive imaging (magnetic resonance imaging (MRI), and prophylactic surgery (Hollingsworth et al., 2002; Saslow et al., 2007). A standardized algorithm for breast cancer risk assessment is not available at this time in the clinical setting. Women are categorized as either having possible genetic or hereditary risk, or as having risk factors unrelated to a family history of breast cancer. Genetic testing is limited as a risk assessment tool, as only a small percentage of women carry known genetic mutations which result in an increased risk of breast cancer development. Mathematical models (i.e., Gail index) calculate probabilities of developing breast cancer during specified periods of time; however, the factors included in the models contribute a relatively small degree of risk for the eventual development of breast cancer. Hollingsworth et al. (2002) suggested that tissue or serum-based strategies should be the next step in refining risk assessment, considering that 70% of women who develop breast cancer have no identifiable risk factors.

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

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 309.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 399.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 449.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  • Allain, D., Gilligan, M., & Redlich, P. 2002. Genetics and genetic counseling for breast cancer. In W. Donegan & J. Spratt (Eds.)Cancer of the Breast(pp. 249–268). Philadelphia: Saunders

    Google Scholar 

  • Anderson, J. E. 1978.Grant's Atlas of Anatomy(7th ed.). Baltimore: Williams & Wilkins

    Google Scholar 

  • Baltzell, K., Eder, S., & Wrensch, M. 2005. Breast carcinogenesis - can the examination of ductal fluid enhance our understanding?Oncol. Nurs. Forum.32: 33–39

    Article  PubMed  Google Scholar 

  • Baltzell, K. A., Wrensch, M., & Sison, J. D. 2006. A descriptive study of variables associated with obtaining nipple aspirate fluid in a cohort of non-lactating women.BMC Womens Hlth.6: 15

    Article  Google Scholar 

  • Beckmann, M. W., Bani, M. R., Fasching, P. A., Strick, R., & Lux, M. P. 2007. Risk and risk assessment for breast cancer: molecular and clinical aspects.Maturitas.57: 56–60

    Article  PubMed  CAS  Google Scholar 

  • Berry, D., Iversen, E., Gudbjartsson, D., Hiller, E., Garber, J., Peshkin, B., Lerman, C., Watson, P., & Lynch, H. 2002. BRCAPRO validation, sensitivity of genetic testing of BRCA1/BRCA2, and prevalance of other breast cancer susceptibility genes.J. Clin. Oncol.20: 2701–2712

    Article  PubMed  CAS  Google Scholar 

  • Buehring, G., Letscher, A., McGirr, K., Khandhar, S., Che, L., Nguyen, C., & Hackett, A. 2006. Presence of epithelial cells in nipple aspirate fluid is associated with subsequent breast cancer: a 25-year prospective study.Breast Cancer Res. Treat.98: 63–70

    Article  PubMed  Google Scholar 

  • Claus, E., Risch, N., & Thompson, W. 1993. The calculation of breast cancer risk for women with a first degree family history of ovarian cancer.Breast Cancer Res. Treat.28: 115–120

    Article  PubMed  CAS  Google Scholar 

  • Cooper, A. P. 1840.On the Anatomy of the Breast. London: Longmans

    Google Scholar 

  • Dooley, W., Ljung, B., Veronesi, U., Cazzaniga, M., Elledge, R., O'Shaughnessy, J., Kuerer, H., & Khan, S. 2001. Ductal lavage for detection of cellular atypia in women at high risk for breast cancer.J. Natl. Cancer Inst.93: 1624–1632

    Article  PubMed  CAS  Google Scholar 

  • Dua, R. S., Isacke, C. M., & Gui, G. P. 2006. The intraductal approach to breast cancer biomarker discovery.J. Clin. Oncol.24: 1209–1216

    Article  PubMed  Google Scholar 

  • Dupont, W., & Page, D. 1985. Risk factors for breast cancer in women with proliferative breast disease.N. Engl. J. Med.312: 146–151

    PubMed  CAS  Google Scholar 

  • Euhus, D. 2001. Understanding mathematical models for breast cancer risk assessment and counseling.Breast J.7: 224–232

    Article  PubMed  CAS  Google Scholar 

  • Euhus, D. M., Leitch, A. M., Huth, J. F., & Peters, G. N. 2002. Limitations of the Gail model in the specialized breast cancer risk assessment clinic.Breast J.8: 23–27

    Article  PubMed  Google Scholar 

  • Fasching, P. A., Bani, M. R., Nestle-Kramling, C., Goecke, T. O., Niederacher, D., Beckmann, M. W., & Lux, M. P. 2007. Evaluation of mathematical models for breast cancer risk assessment in routine clinical use.Eur. J. Cancer Prev.16: 216–224

    Article  PubMed  Google Scholar 

  • Gail, M., Brinton, L., Byar, D., Corle, D., Green, S., Schairer, C., & Mulvihill, J. J. 1989. Projecting individualized probabilities of developing breast cancer for white females who are being examined annually.J. Natl. Cancer Inst.81: 1879–1886

    Article  PubMed  CAS  Google Scholar 

  • Going, J. J., & Moffat, D. F. 2004. Escaping from Flatland: clinical and biological aspects of human mammary duct anatomy in three dimensions.J. Pathol.203: 538–544

    Article  PubMed  Google Scholar 

  • Harris, J., Lippman, M., Morrow, M., & Osborne, C. (Eds.). 2004.Diseases of the Breast(3rd ed.). Philadelphia: Lippincott Williams & Wilkins

    Google Scholar 

  • Hartmann, L., Schaid, D., Woods, J., Crotty, T., Myers, J., Arnold, P., & Petty, P. 1999. Efficacy of bilateral prophylactic mastectomy in women with a family history of breast cancer.N. Engl. J. Med.340: 77–84

    Article  PubMed  CAS  Google Scholar 

  • Higgins, S. A., Matloff, E. T., Rimm, D. L., Dziura, J., Haffty, B. G., & King, B. L. 2005. Patterns of reduced nipple aspirate fluid production and ductal lavage cellularity in women at high risk for breast cancer.Breast Cancer Res.7: R1017–R1022

    Article  PubMed  Google Scholar 

  • Hollingsworth, A. B., Nall, S., & Dill, D. 2002. The evolution of breast cancer risk assessment.J. Okla. State Med. Assoc.95: 639–644

    PubMed  Google Scholar 

  • Jemal, A., Murray, T., Ward, E., Samuels, A., Tiwari, R., Ghafoor, A., Feuer, E., & Thun, M. J. 2005. Cancer statistics, 2005.CA: Cancer J. Clin.55: 10–30

    Article  Google Scholar 

  • Kato, I., Ren, J., Visscher, D. W., & Djuric, Z. 2006. Nutritional predictors for cellular nipple aspirate fluid: nutrition and breast health study.Breast Cancer Res. Treat.97: 33–39

    Article  PubMed  Google Scholar 

  • Kerlikowske, K., Ichikawa, L., Miglioretti, D. L., Buist, D. S., Vacek, P. M., Smith-Bindman, R., Yankaskas, B., Carney, P. A., & Ballard-Barbash, R. 2007. Longitudinal measurement of clinical mammographic breast density to improve estimation of breast cancer risk.J. Natl. Cancer Inst.99: 386–395

    Article  PubMed  Google Scholar 

  • Khan, S. A., Bhandare, D., & Chatterton, R. T., Jr. 2005. The local hormonal environment and related biomarkers in the normal breast.Endocr. Relat. Cancer 12: 497–510

    Article  PubMed  CAS  Google Scholar 

  • King, B. L., & Love, S. M. 2006. The intraductal approach to the breast: raison d'etre.Breast Cancer Res.8: 206

    Article  PubMed  Google Scholar 

  • King, E. B., Chew, K. L., Petrakis, N. L., & Ernster, V. L. 1983. Nipple aspirate cytology for the study of breast cancer precursors.J. Natl. Cancer Inst.71: 1115–1121

    PubMed  CAS  Google Scholar 

  • King, E. B., Chew, K. L., Hom, J. D., Miike, R., Wrensch, M. R., & Petrakis, N. L. 2004. Multiple sampling for increasing the diagnostic sensitivity of nipple aspirate fluid for atypical cytology.Acta. Cytol.48: 813–817

    PubMed  Google Scholar 

  • Klein, P. M., & Lawrence, J. A. 2002. Lavage and nipple aspiration of breast ductal fluids: a source of biomarkers for environmental mutagenesis.Environ. Mol. Mutagen.39: 127–133

    Article  PubMed  CAS  Google Scholar 

  • Ljung, B. M., Chew, K. L., Moore, D. H., II, & King, E. B. 2004. Cytology of ductal lavage fluid of the breast.Diag. Cytopathol.30: 143–150

    Article  Google Scholar 

  • Love, R., Newcomb, P., & Trentham-Dietz, A. (Eds.). 2002.Prevention of Breast Cancer. Philadelphia: Saunders

    Google Scholar 

  • Love, S. M., & Barsky, S. H. 2004. Anatomy of the nipple and breast ducts revisited.Cancer 101: 1947–1957

    Article  PubMed  Google Scholar 

  • Martin, G. 1996. Normal cells and cancer cells. In J. W. Bishop, R. (Ed.)Molecular Oncology. (pp. 13–40). New York: Scientific-American

    Google Scholar 

  • Nejad, M., Tondre, J., Mills, D., & Love, S.M. 2008. Technical enhancements to breast ductal lavage.Ann. Surg, Onc.15(2): 78

    Google Scholar 

  • O'Shaughnessy, J. A. 2000. Treating breast precan-cer.Clin. Breast Cancer 1 Suppl 1: S74–S79

    Article  Google Scholar 

  • Papanicolaou, G., Holmquist, D., Bader, G., & Falk, E. 1958. Exfoliative cytology of the human mammary gland and its value in the diagnosis of cancer and other diseases of the breast.Cancer 11: 377–409

    Article  PubMed  CAS  Google Scholar 

  • Petrakis, N. L. 1986. Physiologic, biochemical, and cytologic aspects of nipple aspirate fluid.Breast Cancer Res. Treat.8: 7–19

    Article  PubMed  CAS  Google Scholar 

  • Petrakis, N. L. 1993. Nipple aspirate fluid in epi-demiologic studies of breast disease.Epidemiol. Rev.15: 188–195

    PubMed  CAS  Google Scholar 

  • Petrakis, N. L., Barnes, S., King, E. B., Lowenstein, J., Wiencke, J., Lee, M. M., Miike, R., Kirk, M., & Coward, L. 1996. Stimulatory influence of soy protein isolate on breast secretion in pre-and postmenopausal women.Cancer Epidemiol. Biomarkers Prev.5: 785–794

    PubMed  CAS  Google Scholar 

  • Ramsay, D. T., Kent, J. C., Hartmann, R. A., & Hartmann, P. E. 2005. Anatomy of the lactating human breast redefined with ultrasound imaging.J. Anat.206: 525–534

    Article  PubMed  CAS  Google Scholar 

  • Rose, D., Lahti, H., Laakso, K., Kettunen, K., & Wynder, E. 1986. Serum and breast duct fluid prolactin and estrogen levels in healthy Finnish and American women and patients with fibro-cystic disease.Cancer 57: 1550–1554

    Article  PubMed  CAS  Google Scholar 

  • Rusby, J. E., Brachtel, E. F., Michaelson, J. S., Koerner, F. C., & Smith, B. L. 2007. Breast duct anatomy in the human nipple: three-dimensional patterns and clinical implications.Breast Cancer Res. Treat.106: 171–179

    Article  PubMed  Google Scholar 

  • Sakorafas, G. H., Krespis, E., & Pavlakis, G. 2002. Risk estimation for breast cancer development; a clinical perspective.Surg. Oncol.10: 183–192

    Article  PubMed  Google Scholar 

  • Sartorius, O., Smith, H., Morris, P., Benedict, D., & Friesen, L. 1977. Cytologic evaluation of breast fluid in the detection of breast disease.J. Natl. Cancer Inst.59: 1073–1078

    PubMed  CAS  Google Scholar 

  • Saslow, D., Boetes, C., Burke, W., Harms, S., Leach, M. O., Lehman, C. D., Morris, E., Pisano, E., Schnall, M., Sener, S., Smith, R. A., Warner, E., Yaffe, M., Andrews, K. S., & Russell, C. A. 2007. American cancer society guidelines for breast screening with MRI as an adjunct to mammography.CA Cancer J. Clin.57: 75–89

    PubMed  Google Scholar 

  • Sauter, E. R., Chervoneva, I., Diamandis, A., Khosravi, J. M., Litwin, S., & Diamandis, E. P. 2002. Prostate-specific antigen and insulinlike growth factor binding protein-3 in nipple aspirate fluid are associated with breast cancer.Cancer Detect. Prev.26: 149–157

    Article  PubMed  CAS  Google Scholar 

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

    PubMed  CAS  Google Scholar 

  • Sauter, E. R., Klein, G., Wagner-Mann, C., & Diamandis, E. P. 2004. Prostate-specific antigen expression in nipple aspirate fluid is associated with advanced breast cancer.Cancer Detect. Prev.28: 27–31

    Article  PubMed  Google Scholar 

  • Sauter, E. R., Winn, J. N., Dale, P. S., & Wagner-Mann, C. 2006. Nipple aspirate fluid color is associated with breast cancer.Cancer Detect. Prev.30: 322–328

    Article  PubMed  Google Scholar 

  • Sauter, E. R., Wagner-Mann, C., Ehya, H., & Klein-Szanto, A. 2007. Biologic markers of breast cancer in nipple aspirate fluid and nipple discharge are associated with clinical findings.Cancer Detect. Prev.31: 50–58

    Article  PubMed  Google Scholar 

  • Singletary, S. E. 2003. Rating the risk factors for breast cancer.Ann. Surg.237: 474–482

    Article  PubMed  Google Scholar 

  • Teboul, M., & Halliwell, M. 1995.Atlas of Ultrasound and Ductal Echography of the Breast: the Introduction of Anatomic Intelligence into Breast Imaging. Oxford: Blackwell Science

    Google Scholar 

  • Tice, J. A., Miike, R., Adduci, K., Petrakis, N. L., King, E., & Wrensch, M. R. 2005. Nipple aspirate fluid cytology and the Gail model for breast cancer risk assessment in a screening population.Cancer Epidemiol. Biomarkers Prev.14: 324–328

    Article  PubMed  Google Scholar 

  • Tot, T. 2005. DCIS, cytokeratins, and the theory of the sick lobe.Virchows Arch.447: 1–8

    Article  PubMed  Google Scholar 

  • Tyrer, J., Duffy, S. W., & Cuzick, J. 2004. A breast cancer prediction model incorporating familial and personal risk factors.Stat. Med.23: 1111–1130

    Article  PubMed  Google Scholar 

  • 1997. The uniform approach to breast fine-needle aspiration biopsy. NIH Consensus Development Conference.Am. J. Surg.174: 371–385

    Google Scholar 

  • Winer, E., Morrow, M., Osborne, C., & Harris, J. 2001. Malignant tumors of the breast. In V. Devita, S. Hellman, & S. Rosenberg (Eds.)Cancer: Principles & Practice of Oncology(pp. 1651–1716). Phildelphia: Lippincott

    Google Scholar 

  • Wrensch, M. R., Petrakis, N. L., King, E. B., Miike, R., Mason, L., Chew, K. L., Lee, M. M., Ernster, V. L., Hilton, J. F., Schweitzer, R.et al. 1992. Breast cancer incidence in women with abnormal cytology in nipple aspirates of breast fluid.Am. J. Epidemiol.135: 130–141

    PubMed  CAS  Google Scholar 

  • Wrensch, M. R., Petrakis, N. L., Miike, R., King, E. B., Chew, K., Neuhaus, J., Lee, M. M., & Rhys, M. 2001. Breast cancer risk in women with abnormal cytology in nipple aspirates of breast fluid.J. Natl. Cancer Inst.93: 1791–1798

    Article  PubMed  CAS  Google Scholar 

  • Zhao, Y. , Verselis, S. J., Klar, N., Sadowsky, N. L., Kaelin, C. M., Smith, B., Foretova, L., & Li, F. P. 2001. Nipple fluid carcinoembryonic antigen and prostate-specific antigen in cancer-bearing and tumor-free breasts.J. Clin. Oncol.19: 1462–1467

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2008 Springer Science + Business Media B.V.

About this chapter

Cite this chapter

Baltzell, K., Mills, D., Ljung, BM., Love, S., Wrensch, M. (2008). Breast Cancer Risk in Women with Abnormal Cytology in Nipple Aspirate Fluid. In: Hayat, M.A. (eds) Methods of Cancer Diagnosis, Therapy and Prognosis. Methods of Cancer Diagnosis, Therapy and Prognosis, vol 1. Springer, Dordrecht. https://doi.org/10.1007/978-1-4020-8369-3_16

Download citation

  • DOI: https://doi.org/10.1007/978-1-4020-8369-3_16

  • Publisher Name: Springer, Dordrecht

  • Print ISBN: 978-1-4020-8368-6

  • Online ISBN: 978-1-4020-8369-3

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics