The Pap Smear for Breasts
A new diagnostic procedure has been called a “pap smear for breasts.” It does for breast cancer what the Pap test has done for cervical cancer. It provides a means for the early detection of breast cancer.
The test procedure calls for placement of a tiny tube in the patient’s nipple. A saline solution is sent through the tiny tube and into the breast duct. That saline solution allows the physician to wash out from the duct any loose cells. The physician then extracts the wash fluid from the patient’s breast ducts.
Analysis of the extracted fluid can be accomplished in one of two ways. Either the physician analyzes the fluid under a microscope or the physician sends the sample to a lab, where it is analyzed by means of cell cytometry. During either type of analysis, the examiner must look for a sign of cancer cells.
The beauty of this diagnostic test derives from the fact that it can by done during an office visit; it does not require surgery. The one problem with this test becomes apparent if analysis of the wash fluid shows the presence of cancer cells. The physician can not determine where in the breast the cells came from.
A positive result from this screening test would doubtless lead to a call from the patient’s physician, a call requesting that the patient have a mammogram. The mammogram, though an older technology, would supplement the data from the cytopathology. The cytopathology allows the sorting of the cells, grouping together all those with a DNA level higher than that expected for a non-cancerous cell.
While such grouping helps to confirm the presence of suspected cancer cells, it does not confirm their existence in the patient’s breast. Nevertheless, Dr. Sara Sukumer and Dr. Mary Jo Fackler, both at John Hopkins Kimmel Cancer Institute, praise this new test for breast cancer. They have said, “This screening method can see what the eye cannot see.”
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