Cells in breast fluid may predict risk for breast cancer, study suggests

Wednesday, December 5th 2001, 12:00 am
By: News On 6

WASHINGTON (AP) _ Researchers who studied specimens from thousands of women suggest that the presence of abnormal cells in breast fluid may predict a doubled risk of breast cancer.

In a study appearing Wednesday in the Journal of the National Cancer Institute, the researchers said that analyzing breast fluids extracted from nonpregnant and nonlactating women showed that those with abnormal cells were twice as likely to develop breast cancer.

Women from whom no fluid could be drawn, the study showed, had the lowest risk of breast cancer while those with normal cells in the fluid were at about a 60 percent higher 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 when a woman who is not pregnant or nursing produces fluid, it 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, genetic makeup, the results of physical examinations, and biopsies.

She cautioned that 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.

``One doesn't want a woman to go away thinking that she has been given a guarantee of low risk because no cells were obtained,'' said Kimler. ``She can still have other factors that confer increased risk.''

In the study, Wrensch and her colleagues analyzed the breast cancer histories of two groups of women, totaling 7,673, from whom health care workers had attempted to take breast fluids. About 60 percent of the women produced fluids. Specimens from the first group were taken from 1971 to 1980, while the second group was enrolled in the study from 1981 to 1991.

The fluids were obtained by use of a manual breast pump that mimicked the suction force of a nursing infant.

An analysis showed that fluids from 38.1 percent of the women contained only normal cells, while specimens from 15.2 percent had abnormal cells. The researchers said 7.5 percent of the women produced fluids that could not be analyzed.

Among those women with abnormal cells in the breast fluid, 19.2 percent later developed breast cancer, compared to 3.7 percent of those women who produced no fluids. Among women whose breast fluid contained only normal cells, about 6.6 percent developed breast cancer. By factoring in other risk factors for breast cancer, Wrensch said the researchers concluded the abnormal cells about doubled the risk of the disease.

Wrensch said that other techniques, including needles, have been proposed to obtain breast fluids for analysis, but she found that women objected less to the breast pump than to the more invasive procedures.

``It does have the disadvantage in that you do not get fluids from all women,'' she said, which means the technique could not be used on some patients.