Breast Duct Endoscopy as a Means of Obtaining and Studying Precancerous DuctalEpithelial Cells

摘要

One limiting factor all of breast cancer prevention research has been our lack ofintermediate markers of breast cancer risk. The main reason we have been unable to identify such markers is that we do not have ready, reproducible, non traumatic access to the lining epithelium. Since most breast cancer starts in the epithelial lining of one of the six-to-nine milk ducts found in each breast, breast duct endoscopy and pathological Icytological analysis is an ideal means of gaining access to the ductal epithelia cells and diagnosing, treating and studying the precancerous state. Using a flexible duct endoscope, the breast ducts of seven of nine patients with ductal carcinomas in situ (DCIS) and/or invasive breast cancer ave been success fully cannulated and studied by cytological and pathological analysis. Contrast dyes including methylene blue, gastrograffin, and barium sulfate injected into the cannulated ducts have also demonstrated a number of important observations with respect to both the normal ductal system as well as DCIS. In addition, we have shown that the ductal system of the breast is a non-anastomosin three dimensional network composed of ducts and acini.