The evolution of the intraductal approach has been slow until the last decade. George Papanicolaou [
] proposed a screen for breast cancer using nipple fluid, but the relative scarceness of nipple fluid clinically discouraged enthusiasm for this approach. In the 1960s, Otto Sartorius [
- Papanicolaou G.N.
- Holmquist D.G.
- Bader G.M.
- et al.
Exfoliative cytology of the human mammary gland and its value in the diagnosis of cancer and other diseases of the breast.
Cancer. 1958; 11: 377-409
], a private practice breast surgeon in Southern California, and colleagues began intensive efforts with both nipple fluid cytology and galactograms to identify intraductal precursors of breast cancer. They had limited success at identifying some subcentimeter breast cancers, but the lack of publication of their efforts left the field incomplete and fallow. By the late 1960s, interest by researchers at the University of California, San Francisco (UCSF) inspired a longitudinal study of nipple fluid in women in the San Francisco bay area. The combined studies of this era have now given us almost 30 years of follow-up of a standardized approach to nipple aspiration, and the meaning of both fluid production and cytologic changes within that fluid [
- Sartorius O.W.
- Smith H.S.
- Morris P.
- et al.
Cytologic evaluation of breast fluid in the detection of breast disease.
J Natl Cancer Inst. 1977; 59: 1073-1078
]. As longer follow-up of these original nipple aspiration studies showed increasing clinical relevance, the late 1990s showed renewed interest in an intraductal approach to both breast cancer and precancer detection amongst United States researchers.
- Wrensch M.R.
- Petrakis N.L.
- King E.B.
- et al.
Breast cancer incidence in women with abnormal cytology in nipple aspirates of breast fluid.
Am J Epidemiol. 1992; 135: 130-141
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© 2005 Elsevier Inc. Published by Elsevier Inc. All rights reserved.