Dr. Masood helps lead NCI workshop on ductal lavage

Analyzing cells from breast fluid, where breast cancer often starts, looks promising as a way to detect cellular changes associated with increased risks for breast cancer, but national experts say the procedure is not ready for “prime time” for this purpose.

Several dozen medical researchers, taking part in a Sept. 15 workshop sponsored by the National Cancer Institute, agreed that extensive, well-controlled clinical trials are needed to accurately determine the value of the risk assessment tool known as ductal lavage. The Food and Drug Administration-approved procedure involves the use of suction to draw ductal fluid to the nipple’s surface, after which the duct is rinsed and cells are collected through a catheter and sent to a laboratory for analysis.

University of Florida pathology Professor Shahla Masood, M.D., who joined Victor Vogel, M.D., from the University of Pennsylvania, in leading the meeting, said the participants are now preparing a written summary of the workshop with a priority list of topics for future research.

Based on information shared at the workshop and her own clinical experience, Masood suggests that pathologists should be enlisted to better define the criteria for prognostically relevant abnormalities detected through ductal lavage and to provide opportunities for sharing the information among themselves. She also noted that the morphology of breast fluid cells needs to be integrated with information gained through molecular biology and contemporary breast imaging technologies.

Masood, who is in her third year of using ductal lavage in the monitoring of high-risk patients through the Breast Health Center at Shands Jacksonville, said the procedure appears to have benefits beyond cancer detection.

“I’ve found it is an incredible tool for helping to pinpoint early breast lesions, particularly in patients with nipple discharge, and for helping us accurately diagnose the spectrum of breast pathologies that are apparent clinically and cannot be found on mammograms and ultrasound exams,” she said.

Masood is associate chairwoman for the College of Medicine’s department of pathology and laboratory medicine. She also is the founding president of the International Society for Breast Pathology.