Breast Cancer

Ductal Lavage

New surgical procedure to detect breast cancer

Involved very early in a breast cancer case, the surgeon plays a pivotal role in both the detection and treatment of breast cancer. Now with two new surgical options for patients, the ability to detect breast cancer early is giving Scott & White doctors a new advantage over the disease.

Traditionally, besides a biopsy, little else could be done surgically to detect breast cancer. But new technology could help change that. One new procedure called ductal lavage helps give surgeons a closer look at the cells within the breast, to help them find any abnormalities early. Used mainly in patients at high risk for the disease (due to either a family history or personal history of breast cancer), this technique involves placing a tiny catheter into the nipple, instilling fluid and then collecting the cells lining the milk ducts and looking at them under a microscope.

“Ductal lavage gives us an advantage in finding breast cancer early because we are actually able to evaluate the cells that may become cancerous,” said Darlene Miltenburg, M.D., chief of breast surgery at Scott & White. “With the ductal lavage, we can look at the cells that theoretically may become cancerous, giving us insight into whether or not the woman faces the possibility of developing breast cancer.”

Another procedure, called nipple ductoscopy, allows the surgeon to actually look into the milk ducts, where breast cancer starts. One of only 100 medical centers in the United States using nipple ductoscopy, Scott & White is utilizing this new technology on women who might experience discharge from their nipples. The procedure involves using a fiber optic cable with a tiny telescope that is inserted into the nipple. The images from the camera allow the surgeon to see inside the duct and search for any abnormalities or any cancers that might be growing. If something is found, it is then removed.

“This new technology is allowing us to do phenomenal things,” Dr. Miltenburg said. “Our fiber optic scope gives us an incredible view of the inside of the breast, and we can look for tumors, abnormal cells, anything. Then if we do find something, we can do a precise biopsy and remove the abnormality without having to remove the normal surrounding breast tissue. This provides us with a wonderful opportunity to detect breast cancer at a very early stage.”

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