Repeated Nipple Fluid Aspiration: Compliance and Feasibility Results from a Prospective Multicenter Study

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2015 May 23

PMID 26000714

Citations 7

Authors

J S de Groot

C B Moelans

S G Elias

A Hennink

B Verolme

K P M Suijkerbuijk

A Jager

C Seynaeve

P Bos

A J Witkamp

M G E M Ausems

P J van Diest

E van der Wall

Affiliations

Soon will be listed here.

Abstract

Background: Despite intensive surveillance, a high rate of interval malignancies is still seen in women at increased breast cancer risk. Therefore, novel screening modalities aiming at early detection remain needed. The intraductal approach offers the possibility to directly sample fluid containing cells, DNA and proteins from the mammary ductal system where, in the majority of cases, breast cancer originates. Fluid from the breast can non-invasively be obtained by oxytocin-assisted vacuum aspiration, called nipple fluid aspiration (NFA). The goal of this feasibility study was to evaluate the potential of repeated NFA, which is a critical and essential step to evaluate its possible value as a breast cancer screening method.

Methods: In this multicenter, prospective study, we annually collected nipple fluid for up to 5 consecutive years from women at increased breast cancer risk, and performed a questionnaire-based survey regarding discomfort of the aspiration. Endpoints of the current interim analyses were the feasibility and results of 994 NFA procedures in 451 women with total follow-up of 560 person years of observation.

Results: In this large group of women at increased risk of breast cancer, repetitive NFA appeared to be feasible and safe. In 66.4% of aspirated breasts, nipple fluid was successfully obtained. Independent predictive factors for successful NFA were premenopausal status, spontaneous nipple discharge, smaller breast size, bilateral oophorectomy and previous use of hormone replacement therapy or anti-hormonal treatment. The procedure was well tolerated with low discomfort. Drop-out rate was 20%, which was mainly due to repeated unsuccessful aspiration attempts. Only 1.6% of women prematurely declined further participation because of side effects.

Conclusions: Repeated NFA in women at increased breast cancer risk is feasible and safe. Therefore, NFA is a promising method to non-invasively obtain a valuable source of potential breast cancer specific biomarkers.

Citing Articles

Patient-centered research: how do women tolerate nipple fluid aspiration as a potential screening tool for breast cancer?.

Patuleia S, Moelans C, Koopman J, van Steenhoven J, van Dalen T, van der Pol C BMC Cancer. 2022; 22(1):705.

PMID: 35761221 PMC: 9235076. DOI: 10.1186/s12885-022-09795-8.

Nipple aspirate fluid and its use for the early detection of breast cancer.

Jiwa N, Ezzat A, Holt J, Wijayatilake D, Takats Z, Leff D Ann Med Surg (Lond). 2022; 77:103625.

PMID: 35638006 PMC: 9142541. DOI: 10.1016/j.amsu.2022.103625.

Nipple Aspirate Fluid at a Glance.

Patuleia S, Suijkerbuijk K, van der Wall E, van Diest P, Moelans C Cancers (Basel). 2022; 14(1).

PMID: 35008326 PMC: 8750428. DOI: 10.3390/cancers14010159.

Breast health screening: a UK-wide questionnaire.

Jiwa N, Takats Z, Leff D, Sutton C BMJ Nutr Prev Health. 2021; 4(1):206-212.

PMID: 34308128 PMC: 8258049. DOI: 10.1136/bmjnph-2021-000266.

The Physiological MicroRNA Landscape in Nipple Aspirate Fluid: Differences and Similarities with Breast Tissue, Breast Milk, Plasma and Serum.

Patuleia S, van Gils C, Oneto Cao A, Bakker M, van Diest P, van der Wall E Int J Mol Sci. 2020; 21(22).

PMID: 33187146 PMC: 7696615. DOI: 10.3390/ijms21228466.

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