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

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...

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Autores principales: de Groot, J. S., Moelans, C. B., Elias, S. G., Hennink, A., Verolme, B., Suijkerbuijk, K. P. M., Jager, A., Seynaeve, C., Bos, P., Witkamp, A. J., Ausems, M. G. E. M., van Diest, P. J., van der Wall, E.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4441497/
https://www.ncbi.nlm.nih.gov/pubmed/26000714
http://dx.doi.org/10.1371/journal.pone.0127895
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author de Groot, J. S.
Moelans, C. B.
Elias, S. G.
Hennink, A.
Verolme, B.
Suijkerbuijk, K. P. M.
Jager, A.
Seynaeve, C.
Bos, P.
Witkamp, A. J.
Ausems, M. G. E. M.
van Diest, P. J.
van der Wall, E.
author_facet de Groot, J. S.
Moelans, C. B.
Elias, S. G.
Hennink, A.
Verolme, B.
Suijkerbuijk, K. P. M.
Jager, A.
Seynaeve, C.
Bos, P.
Witkamp, A. J.
Ausems, M. G. E. M.
van Diest, P. J.
van der Wall, E.
author_sort de Groot, J. S.
collection PubMed
description 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.
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spelling pubmed-44414972015-05-28 Repeated Nipple Fluid Aspiration: Compliance and Feasibility Results from a Prospective Multicenter Study de Groot, J. S. Moelans, C. B. Elias, S. G. Hennink, A. Verolme, B. Suijkerbuijk, K. P. M. Jager, A. Seynaeve, C. Bos, P. Witkamp, A. J. Ausems, M. G. E. M. van Diest, P. J. van der Wall, E. PLoS One Research Article 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. Public Library of Science 2015-05-22 /pmc/articles/PMC4441497/ /pubmed/26000714 http://dx.doi.org/10.1371/journal.pone.0127895 Text en © 2015 de Groot et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
de Groot, J. S.
Moelans, C. B.
Elias, S. G.
Hennink, A.
Verolme, B.
Suijkerbuijk, K. P. M.
Jager, A.
Seynaeve, C.
Bos, P.
Witkamp, A. J.
Ausems, M. G. E. M.
van Diest, P. J.
van der Wall, E.
Repeated Nipple Fluid Aspiration: Compliance and Feasibility Results from a Prospective Multicenter Study
title Repeated Nipple Fluid Aspiration: Compliance and Feasibility Results from a Prospective Multicenter Study
title_full Repeated Nipple Fluid Aspiration: Compliance and Feasibility Results from a Prospective Multicenter Study
title_fullStr Repeated Nipple Fluid Aspiration: Compliance and Feasibility Results from a Prospective Multicenter Study
title_full_unstemmed Repeated Nipple Fluid Aspiration: Compliance and Feasibility Results from a Prospective Multicenter Study
title_short Repeated Nipple Fluid Aspiration: Compliance and Feasibility Results from a Prospective Multicenter Study
title_sort repeated nipple fluid aspiration: compliance and feasibility results from a prospective multicenter study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4441497/
https://www.ncbi.nlm.nih.gov/pubmed/26000714
http://dx.doi.org/10.1371/journal.pone.0127895
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