Breast Cancer Research and Treatment

, Volume 13, Issue 1, pp 71–78 | Cite as

Nipple aspirate fluids in adult nonlactating women — lactose content, cationic Na+, K+, Na+/K+ ratio, and coloration

  • Nicholas L. Petrakis
  • Mu Lan Lim
  • Rei Miike
  • Rose E. Lee
  • Maureen Morris
  • Linda Lee
  • Lynn Mason
Report

Summary

The presence of lactose in nipple secretions is considered biochemical evidence of breast secretory activity, and has been reported to occur more frequently in white compared to brownish or green colored breast fluid. We studied lactose, Na+, and K+ concentrations, the Na+/K+ ratio, and the coloration of nipple aspirate fluid (NAF) from 49 nonpregnant women.

A significant relationship was found between the concentrations of lactose, Na+, and K+, and age and the coloration of NAF. Lactose was present in 22/49 (44.8%) of the NAF samples and declined with age from 100% positivity in women ≤29 years to 29% in those ≤35 years. In NAF of deep yellow, brown and green colorations, only traces of lactose were found. Na+ and K+ increased with age and with darker colorations compared to white, pale yellow, or colorless NAF.

Lactose was present in NAF samples from both parous and nulliparous younger women, indicating that the breasts of many nonpregnant women respond to prolactin stimulation; hence, lactose may provide a simple marker indicating active physiologic secretory activity of the breast.

As reported previously, NAF of darker coloration, containing elevated levels of cholesterol, cholesterol oxidation products, and other substances, suggests retention and impaired reabsorption of these and other products of secretion. Because of the secretion and temporary retention by the breast glands of chemical substances of exogenous and endogenous origin, including mutagens and carcinogens, lactose concentration and coloration of NAF may be useful as markers of secretion and reabsorption in future physiologically based clinical and epidemiologic studies of the pathogenesis of breast disease.

Key words

breast coloration lactose Na+ K+ Na+/K+ ratio nipple aspirate fluid 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Petrakis NL: Physiologic, biochemical, and cytologic aspects of nipple aspirate fluid. Breast Cancer Res Treat 8: 7–19, 1986PubMedGoogle Scholar
  2. 2.
    Yen SCC, Jaffe RB (eds) Reproductive Endocrinology: Physiology, Pathology, and Clinical Management, 2nd ed. Saunders, Philadelphia, 1986Google Scholar
  3. 3.
    Friedman S, Goldfein A: Breast secretion in normal women. Am J Obstet Gynecol 104: 846–849, 1969PubMedGoogle Scholar
  4. 4.
    Lavric M, Dolar J: Lactose, sodium and potassium content of breast secretion in normal parturient. Obstet Gynecol 42: 107–111, 1973PubMedGoogle Scholar
  5. 5.
    Hagler L, Coppes RI, Block HB, Hofeldt FD, Herman RH: Clinical implications of lactose-positive breast secretions in nonpuerperal females. Obstet Gynecol 46: 302–307, 1975PubMedGoogle Scholar
  6. 6.
    Chotiner HC, Adams HR, Splekerman AM, Gilliand PF, Newmark SR: Lactose and casein content of nonpuerperal breast secretion. J Reprod Med 22: 267–270, 1979PubMedGoogle Scholar
  7. 7.
    Kulski JK, Hartmann PE, Saint WJ, Giles PF, Gutteridge DH: Changes in the milk composition of nonpuerperal women. Am J Obstet Gynecol 139: 597–604, 1981PubMedGoogle Scholar
  8. 8.
    Petrakis NL, Lee RE, Miike R, Dupuy ME, Morris M: Coloration of breast fluid related to concentration of cholesterol, cholesterol epoxides, estrogen, and lipid peroxides. Am J Clin Pathol 89: 117–120, 1988PubMedGoogle Scholar
  9. 9.
    Petrakis NL, Miike R, King EB, Lee L, Mason L, Chang-Lee B: Association of breast fluid coloration with age, ethnicity, and cigarette smoking. Breast Cancer Res Treat 11: 255–262, 1988PubMedGoogle Scholar
  10. 10.
    Mepham TB (ed): Biochemistry of Lactation. Elsevier, Amsterdam, 1983Google Scholar
  11. 11.
    Wynder EL, Hill P: Prolactin, oestrogens and lipids in breast fluid (letter). Lancet 2: 840, 1977PubMedGoogle Scholar
  12. 12.
    Hill P, Garbaczewski L, Wynder EL: Testosterone in breast fluid (letter). Lancet 1: 761, 1983Google Scholar
  13. 13.
    Rose DP, Tilton K, Lahti H, Wynder EL: Progesterone levels in breast duct fluid (letter). Eur J Cancer Clin Oncol 22: 111–113, 1986PubMedGoogle Scholar
  14. 14.
    Petrakis NL, Wrensch MR, Ernster VL, Miike R, Murai J, Simberg N, Siiteri PK: Influence of pregnancy and lactation on serum and breast fluid levels: Implications for breast cancer risk. Int J Cancer 40: 587–591, 1987PubMedGoogle Scholar
  15. 15.
    Rose DP, Berke B, Cohen LA, Lahti H: A comparison of serum and breast duct fluid. Immunoassayable prolactin and growth hormone with bioassayable lactogenic hormones in healthy women and patients with cystic breast disease. Cancer 60: 2761–2765, 1987PubMedGoogle Scholar
  16. 16.
    Djiane J, Durand P: Prolactin-progesterone antagonism in self-regulation of prolactin receptors in the mammary gland. Nature 266: 641–643, 1977PubMedGoogle Scholar

Copyright information

© Kluwer Academic Publishers 1989

Authors and Affiliations

  • Nicholas L. Petrakis
    • 1
  • Mu Lan Lim
    • 1
  • Rei Miike
    • 1
  • Rose E. Lee
    • 1
  • Maureen Morris
    • 1
  • Linda Lee
    • 1
  • Lynn Mason
    • 1
  1. 1.Department of Epidemiology and International Health, School of MedicineUniversity of CaliforniaSan FranciscoUSA

Personalised recommendations