In the past, doctors were not able to access this area to test the cells. Ductal lavage involves a two-step process. First, doctors identify the ducts in the breast that produce fluid by using a pump. Doctors want to test the ducts that secrete fluid because they are the ducts at the highest risk of developing cancer. Doctors wash out these ducts with saline to obtain thousands of cells that line the ducts to examine them under a microscope.
Pathologists then determine whether the samples are normal, atypical or malignant.
A mammogram's ability to detect breast cancer can be limited in the very earliest stages where we would ideally like to detect it, even before the cancer has started to form. The concept behind ductal lavage is very similar to the screening for cervical cancer, the Pap smear. Like a Pap smear, ductal lavage takes cells from where the cancer begins. The procedure is done under local anesthetic. Once the fluid producing ducts are identified, a very fine catheter is inserted into the ducts.