WASHINGTON — Women with abnormal cells in breast fluid are twice as likely to develop breast cancer, says a study that evaluated the disease risk in more than 7,600 women.
The study, appearing today in the Journal of the National Cancer Institute, classified thousands of women by the types of cells found in fluids that had been drawn from their breasts using a mild suction device. None of the women in the study were pregnant or lactating.
After following the women for up to three decades, the researchers found those whose breast fluid contained abnormal cells were twice as likely to develop breast cancer later in life. Women from whom no fluid could be drawn were the least likely to have breast cancer, while those with normal cells in the fluid were at about 60 percent greater risk.
"Our study shows that if you can get fluid from a woman and there are abnormal cells in that fluid, then it is an indication of increased risk of breast cancer," said Margaret R. Wrensch, an epidemiologist at the University of California, San Francisco, School of Medicine and the first author of the study.
She said the study suggests, but does not prove, that for a woman who is not pregnant or nursing to produce any fluid at all may be an indication of increased risk.
"We think that some women have some fluid in their breast ducts all of the time," said Wrensch. "We don’t understand … why we can obtain fluid from some women and not from others." She said the fluid could signal that there are changes underway in the breast.
Wrensch said the results of the study suggest that an analysis of breast fluid should be considered for inclusion on the list of factors that doctors now evaluate when predicting a woman’s breast cancer risk. Other risk factors include close family members with breast cancer, age and the results of physical examinations and biopsies.
"I think our study shows that (obtaining breast fluids) is a valid technique for predicting risk," Wrensch said. "But further work is needed to determine" how it would be used in routine patient care.
Dr. Bruce F. Kimler, a cancer specialist at the University of Kansas Medical Center in Kansas City, Kan., urged caution in using cells from breast fluid as a predictor of breast cancer risk.
He said the procedure to obtain the breast fluid is "well-tolerated" and could be performed in most doctors’ offices.
But if the procedure does not produce fluid, he said, "one should not interpret this to mean that a woman is at low, short-term risk" of breast cancer.
On the Net:
Journal of the National Cancer Institute: http://jnci.oupjournals.org/
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