Combined ductal lavage and ductoscopy: what is the future for the intraductal approach?

摘要

Contemporary thought suggests that breast cancer evolves through a series of mutations that cause normal ductal epithelial cells to progress through hyperplasia, atypical hyperplasia and then to in situ and ultimately to invasive cancer. Despite years of research, the precise changes that result in this malignant transformation are poorly understood. In the ideal world, we would be able to identify those factors in a woman that result in susceptibility to the development of cancer. We would then be able to intervene and prevent malignant transformation. Currently our ability to predict which women will develop breast cancer is predicated on analyzing factors that identify a higher statistical risk of developing cancer, screening for genetic mutations, and determining known histologic features through biopsy that have been demonstrated to be associated with breast cancer risk development, that is, atypical hyperplasia or lobular carcinoma in situ.