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Pap Test for Breast Cancer - The HALO Test

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Updated October 15, 2008

HALO Breast Pap Test Equipment

HALO Breast Pap Test Equipment

Photo © NeoMatrix

Stopping Breast Cancer Before it Gets Started:

Abnormal breast cells don't turn into a tumor overnight – it starts with a cell, just one cell – that is damaged or is malfunctioning. Gradually, there are two, four, then eight abnormal cells living in your breast. You can't feel a lump from just a few cells, a mammogram or ultrasound won't reveal those cells, and they might not turn into breast cancer. But research shows that having abnormal cells in your nipple fluid is related to an increased risk for breast cancer. Having a breast Pap test could help find those cells and prevent breast cancer from developing.

HALO Breast Pap Test:

A new screening test for breast cancer called HALO uses a non-invasive technology to suction out some nipple aspirate fluid (NAF), which is tested for precancerous cells. The HALO test may be able to help determine your risk for breast cancer up to seven years before a breast self-exam or a mammogram would reveal a lump. The HALO is a screening test, not a diagnostic test. It will not replace having a mammogram, breast self-exam or clinical breast exam.

Importance of Screening Nipple Aspirate Fluid:

Young women and premenopausal women typically have dense breast tissue, which can hide abnormalities during mammography. Women under 40 are discouraged from having annual mammograms, in order to reduce their lifetime exposure to radiation and because of the high rates of inaccurate results. If young women develop breast cancer, it is typically high-grade, aggressive cancer that often requires more aggressive treatment to be successful. Early detection of abnormal breast cells helps to more accurately determine your risk of breast cancer, and lets you start being more vigilant, if needed, about your breast health.

Early Screening – Right Where Most Breast Cancer Starts:

The Pap smear done by your gynecologist is a simple test that screens for cervical cancer. If atypical cells are found, a woman has other tests to determine her diagnosis. Like the cervical Pap smear, the HALO takes a sample of fluid from your nipple and screens it for abnormal cells. Research shows that having abnormal cells, or atypia, in nipple aspirate fluid (NAF), raises your risk of developing breast cancer. Nipple aspirate fluid comes from your milk ducts, where nearly all (95%) of invasive breast cancers begin.

Why Is It Called the Pap Test?:

In 1943, Dr. Papanicolaou and Dr. Herbert Traut published a paper titled, "Diagnosis of Uterine Cancer by the Vaginal Smear." The Pap Smear, used for cervical cancer screening, was named for Dr. Papanicolaou, who in 1958 presented research that proved that the presence of abnormal cells in nipple aspirate fluid successfully identified women who were at high risk for developing breast cancer.

Benefits of the HALO Breast Pap Test:

After doctors began doing annual cervical Pap smears on their patients, the cervical cancer death rate decreased dramatically. Researchers hope that the breast Pap test will cause a great decrease in deaths from breast cancer, and shift the emphasis from "detection and treatment" to "early, accurate screening and prevention."

Cost and Comfort of a HALO Breast Test:

Most health insurance providers do not yet cover the cost of a HALO breast Pap test. You can expect to spend about $100 of your own money for this test. The HALO takes about five minutes, and uses a comfortable amount of heat and suction to collect some fluid from your nipple. No needles or catheters are used, so it isn't an invasive test. Unlike a mammogram, no compression is used.

Getting Test Results:

You'll get results from the lab about one week after your test. Some possible results are:
  • No fluid: normal (not increased) risk for breast cancer
  • Benign nipple discharge: may be caused by medicines, infections, intraductal papillomas, or pregnancy
  • Fluid containing normal cells: twice the normal risk for breast cancer
  • Fluid containing abnormal cells: your risk for breast cancer increases to 4-5 times the normal risk

Actions You Can Take If Your Risk Level Is Greater Than Normal:

After you get your test results, if you find that you have a greater than normal risk for developing breast cancer, you can start taking action. Being at higher risk does not guarantee that you will get breast cancer, but it is a call to action. Take control of these things may help lower your risk:
  • Adopt a healthy lifestyle
  • Don't skip your routine screenings and consider diagnostic, rather than routine mammograms
  • Do your breast self-exam properly, and have annual clinical breast exams
  • Talk to your doctor about drugs and minor surgical procedures that may help reduce your risk
Sources:
American Cancer Society. Overview: Breast Cancer. After the Tests: Staging. Last Revised: 09/16/2008.

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.

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

National Cancer Institute. Collecting Cells for Breast Cancer Biomarker Research - Nipple Aspiration and Ductal Lavage. Posted: 05/30/2002.

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