Mm. Lee et al., ASSOCIATION OF ABNORMAL NIPPLE ASPIRATE CYTOLOGY AND MAMMOGRAPHIC PATTERN AND DENSITY, Cancer epidemiology, biomarkers & prevention, 3(1), 1994, pp. 33-36
The pattern and density of mammograms have been shown to be associated
with proliferative histopathology and an increased risk of breast can
cer. We recently found that epithelial atypia in nipple aspirate fluid
obtained 10-18 years earlier was associated with an increased risk of
breast cancer. In the present study we examined the association betwe
en the cytology of nipple aspirate fluid and mammographic patterns in
588 volunteers recruited from the mammography clinic at the University
of California. Nipple aspirate fluid cytology was classified accordin
g to the most severe epithelial change present and mammograms were cla
ssified by the Wolfe method and the percentage area of density. A dire
ct relationship was found between mammographic density and cytological
abnormality. When controlled for age, body mass index, previous biops
y, and calcification, the odds ratios of high density mammograms (over
50%) with nipple aspirate fluid cytological atypia was 4.4 (95% confi
dence interval, 0.9-21.5; P = 0.08) when normal cytology was the refer
ent. These preliminary findings indicate that highly dense mammograms
are associated with cytological atypia and are consistent with studies
reporting an association of histological hyperplasia and atypical hyp
erplasia with severe mammographic findings. If confirmed by further st
udies, nipple aspirate cytology may be a useful adjunct to mammographi
c patterns in the prediction of breast cancer risk, especially among p
remenopausal women.