ASSOCIATION OF ABNORMAL NIPPLE ASPIRATE CYTOLOGY AND MAMMOGRAPHIC PATTERN AND DENSITY

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.