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What to Expect During a HALO Breast Pap Test

Testing Your Nipple Aspirate Fluid & Screening for Breast Cancer Risk

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Updated October 15, 2008

As part of your annual well-woman exam, you may choose to have a HALO Breast Pap Test, to aspirate nipple fluid that will be screened for abnormal cells. This is a screening test, like a Pap Smear for cervical cancer, which does not diagnose breast cancer but helps determine your risk level. A HALO test does not replace a mammogram, but can be used by women 25 years old and older, to help determine their risk level for breast cancer. Here's what to expect during a HALO breast pap test.

Covering The Cost of a HALO

HALO Breast Pap Test Console
Photo © NeoMatrix
The HALO Breast Pap Test is FDA-approved, but because it is so new, many health insurance companies do not yet cover the cost. Plan on spending about $100 out of pocket for this screening. If you submit a claim to your insurance company, you may be able to recover part of the cost.

A Quick and Comfortable Exam

If you choose to have a HALO test, it will take only five minutes, and can be done right in your clinic. Most women say that it is comfortable, and feels similar to using a breast pump. In a study of 500 women by at the University of Utah, researchers noted that the majority of women tolerated the test quite well, and found it less invasive than ductal lavage or fine needle aspiration. The automated HALO equipment is simple to use, requires just a little training, and is safe for patients.

Preparing for Your HALO Test

HALO Breast Pap Test Collection Cup
Photo © NeoMatrix
You will undress from the waist up, and wear a hospital gown, opening in the front. A nurse will place soft, flexible, latex-free sample collection cups over the adjustable breast suction cups on the HALO console. Your nurse will use antiseptic pads to clean your breasts, with special care for your nipples. This ensures that the sample of nipple fluid is as uncontaminated as possible, for the most accurate results.

During Your HALO Breast Pap Test

HALO Breast Pap Test in Progress
Photo © NeoMatrix
Your nurse will help you properly position the suction and collection cups over your breasts, being sure to center the nipple in the lowest part of the cup. Your nipple aspiration fluid, if any is produced, will be collected at the bottom of the cup. During the test, you will be holding the cups onto your breast skin. Your nurse will start the machine, and your test will begin.

No Compression, Just Warmth and Suction

HALO Breast Pap Test Heat and Suction
Photo © NeoMatrix
With the collection cups in place, the HALO equipment will begin creating suction on your breasts. You will still need to hold the cups in position. After suction starts, you will feel mild warmth and gentle massage from the "petals" around the collection cups on your breast skin. This increases circulation to the nipples and underlying milk ducts.

Collecting Nipple Aspiration Fluid for Testing

HALO Breast Pap Test Fluid Sample
Photo © NeoMatrix
When the suction cycle is complete, your nurse will help you remove the collection cups. If you have any nipple aspiration fluid, it will be collected and sent to the lab for testing. It is completely normal to have no nipple fluid produced, so don't worry if nothing shows up. Nipple fluid may contain benign discharge, which is not worrisome. Only nipple discharge containing abnormal cells is a cause for concern.

Getting Your HALO Test Results

It may take a week to get results of your HALO test back from the lab. Your doctor will contact you with the results and explain what they mean. Some possible results are:
  • No fluid: no concerns and normal (not increased) risk for breast cancer Benign nipple discharge: may be caused by medicines, infections, intraductal papillomas, or pregnancy
  • Fluid containing normal cells: indicates a risk for breast cancer which is twice the normal risk
  • Fluid containing abnormal cells: raises your risk for breast cancer up to 4-5 times the normal risk

Taking Action If Your Risk Level Is Higher Than Normal

After taking the HALO test, if you find that you have a doubled risk or you are at high risk for developing breast cancer, you can start taking action. Being at risk does not mean that you have been diagnosed with breast cancer, but that you have cells that may be in a precancerous state. Taking control of several things may help lower your risk:

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Sources:
Hollingsworth AB, et al. Current comprehensive assessment and management of women at increased risk for breast cancer. Am J Surgery 2004; 187: 349-62.

Jeffrey A. Tice, et al. Nipple Aspirate Fluid Cytology and the Gail Model for Breast Cancer Risk Assessment in a Screening Population. Cancer Epidemiology Biomarkers & Prevention Vol. 14, 324-328, February 2005.

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