Ductal Lavage

Ductal lavage (pronounced DUCK-tull-la-VAJ) is a relatively new technique used to detect pre-cancerous and cancerous breast cell changes in women who are at high risk for developing breast cancer. In ductal lavage, suction is applied to the nipple to bring out fluid from the many little milk ducts that end in the nipple. A small canula, or tiny tube, is placed into the milk duct, and then fluid is washed into the duct to rinse out cells. This fluid is then pulled back out of the nipple and sent to the laboratory for evaluation under the microscope. Some doctors call this technique a "Pap smear" of the breast. (Pap smear is the name of the test most commonly used to detect cervical cancer.)

While there is fairly intense suction applied on the nipple, the small tube placed in the milk duct doesn't hurt. It just feels like a very small poking. So, all in all, it's not considered very uncomfortable.

The controversial part comes from the information we get from this test. While it's wonderful to find any new test that can find cancer early, when we find cancer or abnormal cells in the breast, we need to know where they are coming from. By washing out a milk duct, we may know the general area of the breast that has abnormal cells, but not the exact spot. And we need the exact location to complete a biopsy. So ductal lavage must be done in combination with some sort of imaging study.