• Breast Cancer Risk and Prevention Options
• Clinical Services
• Clinical Trials

Click on Breast Cancer and Risk Factors and Prevention Options to download information on these topics.

Ductal Lavage and Ductoscopy
Ductal Lavage is a new procedure that allows clinicians to access cells and fluid in the breast. Many breast cancers begin to form in the cells lining the milk ducts. Ductal lavage allows us to collect samples of cells from these ducts. These cells are analyzed by a cytopathologist, who determines whether they are normal, atypical or cancerous.

Figures 1 and 2 allow you to visualize how the clinician is able to access the milk duct. First, suction is applied to the nipple and this will draw out breast fluid. Second, the ducts that release breast fluid are marked and the clinician attempts to insert a tiny catheter into the duct to allow for available cells to be collected. The cells that are collected are sent to a laboratory for analysis.

Figures used with permission from Cytyc Health, Inc.

Please visit: www.ductallavage.com for more information on this technique.

Ductoscopy is a similar procedure that allows clinicians to visualize the inside of the breast duct by inserting a tiny camera through the duct. Cells can also be collected from the duct during this procedure. For more information on ductoscopy, please visit www.acueity.com.

Genetic Counseling - Cancer Risk Program
Nearly everyone has at least one family member with cancer. When several family members are affected, suspicions are raised about heritability - especially when cancer occurs at a young age. In some families, genetic testing may identify altered genes that predispose to cancer and are passed from parent to child. Genetic testing results, whether positive or negative, can have profound effects on individuals and their families. Family members with cancer may wish to learn their risk of a second cancer. Family members without cancer who inherit mutant genes may have an increased lifetime risk of developing cancer. These individuals must make critical decisions about surveillance, preventive surgery, and other treatment options.

The UCSF Cancer Risk Program (CRP) was established in 1996 as a multi-disciplinary, genetic counseling service for families with hereditary cancer. Counselors verify the family pedigree, provide education sessions, and offer testing for heritable genetic mutations. Based on the family pedigree and on test results, the counselors and consultant physicians provide an individualized risk management program for each client that includes recommendations for preventive measures and follow-up.

For more information on the Cancer Risk Program, please visit: http://www.cc.ucsf.edu/risk/index.html

Clinical Trials

• Prior or suspected invasive breast cancer of any type; DCIS or LCIS treated by mastectomy, radiation, or systemic adjuvant therapy.
• Bilateral or unilateral prophylactic mastectomy.
• Participating in any other cancer prevention study or osteoporosis prevention study involving pharmacologic intervention(s) (NSABP Protocol P-1 participants who received placebo are eligible.).
• Prior malignancy of any type that occurred less than 10 years previously;
• Existing non-malignant disease that would preclude the administration of tamoxifen or raloxifene.
• Prior history of deep-vein thrombosis or pulmonary embolus;
• Prior history of documented cerebral vascular accident or documented transient ischemic attack.
• Estrogen- or progesterone-replacement therapy, oral contraceptives, or androgens (Women who discontinue these drugs for at least 3 months prior to randomization will be eligible.).
• Tamoxifen, raloxifene, or other SERM therapy (Women who have received these therapies for less than 3 months duration and discontinue the drugs at least 3 months prior to randomization are eligible.).
• Current use of coumadin or cholestyramine.
• Current use of chemotherapy for benign disease.