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Several research groups are currently testing a new method
for detecting
breast cancer that involves
analyzing nipple fluid expressed from the breast. Nipple aspirate fluid, may be drawn out of
the breast using a modified breast pump and then studied under a
microscope to determine whether cancerous cells and other markers
for breast cancer are present. In the most recent study on nipple
fluid, researchers found that women with large breast tumors and
women whose breasts were surgically removed by
mastectomy were likely to have cancerous cells in their nipple fluid.
If further research continues to be positive, nipple fluid analysis
could become a reliable screening tool for breast cancer.
The idea of testing fluid from the nipple was first suggested
in the 1950s by Dr. Papanicolaou, the physician who developed the
Pap smear to test for cervical cancer. Nipple aspirate fluid
contains several cells and proteins that may be analyzed for the
presence of disease. One protein, PSA (protein-specific antigen) is
secreted from the breast ducts—the origin of most breast cancers,
said Edward Sauter, MD, PhD, lead researcher of a nipple aspirate
fluid study at Thomas Jefferson University in Philadelphia.
Researchers were reluctant at first to develop a nipple fluid
analysis test because they previously believed that PSA was only
produced in the male prostate gland. However, recent research has
shown that PSA is also present in the breast and is associated with
an increased breast cancer risk.
Analyzing nipple fluid can be difficult because few women
naturally discharge fluid from their breasts on a
regular basis. However, researchers at the University of California
at Los Angeles (UCLA) have been experimenting with a new technique
to obtain the fluid. Women perform breast massage by placing their
hands flat around the base of the breast and squeezing down toward
the tip of the nipple while a technologist uses a breast pump
(similar to those used by nursing mothers to express milk) to
aspirate the fluid. The research group, led by Susan Love, MD, a
breast surgeon at UCLA, is also in the process of developing a rapid
analysis test of the nipple fluid. Using the breast massage/pump
combination technique, researchers were able to successfully obtain
nipple fluid from more than 80% of the 60 volunteers from clinics at
UCLA and the Olive View Medical Center in Los Angeles.
According to Robert Smith, PhD, director of cancer screenings
for the American Cancer Society (ACS), Dr. Sauter’s research group
has been able to aspirate nipple fluid from nearly all of the women
in their study. Dr. Smith said that the low cost and easy technique
of expressing nipple fluid with a pump should give way to further
research. Presently, several new studies at Thomas Jefferson
University are analyzing nipple fluid in women with no symptoms of
breast cancer.
Currently, x-ray examination of the breasts with mammography is the only method approved by the U.S. Food and Drug
Administration (FDA) to screen for breast cancer in asymptomatic
women (women with no symptoms or signs of breast cancer). Any new
breast cancer screening tool must be at least as effective as
mammography in detecting breast abnormalities (mammography is able
to detect approximately 85% of breast cancers). Surgeons must also
be able to perform a
breast biopsy on the patient to determine
whether the suspicious area is cancerous or benign (non-cancerous)
based on the findings of the exam. Since nipple fluid analysis is
unable to pinpoint the exact location of the cancer in the breast,
additional breast imaging, such as mammography or
ultrasound, would have to be performed before a biopsy could be done.
Nevertheless, researchers call nipple fluid analysis a promising new
development in breast cancer detection.
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References
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