Nipple Aspirate Fluid at a Glance

Abstract

Nipple aspirate fluid (NAF) is an intraductal mammary fluid that, because of its close proximity to and origin from the tissue from which breast cancer originates, is a promising source of biomarkers for early breast cancer detection. NAF can be non-invasively acquired via the nipple by aspiration using a suction device; using oxytocin nasal spray helps increase yield and tolerability. The aspiration procedure is generally experienced as more tolerable than the currently used breast imaging techniques mammography and breast magnetic resonance imaging. Future applications of NAF-derived biomarkers include their use as a tool in the detection of breast carcinogenesis at its earliest stage (before a tumor mass can be seen by imaging), or as a supporting diagnostic tool for imaging, such as when imaging is less reliable (to rule out false positives from imaging) or when imaging is not advisable (such as during pregnancy and breastfeeding). Ongoing clinical studies using NAF samples will likely shed light on NAF’s content and clinical potential. Here, we present a narrative review and perspectives of NAF research at a glance.

Potential utility of miRNAs for liquid biopsy in breast cancer

“…Interestingly, nipple aspirate fluid (NAF) as one of the best samples for detecting miRNAs deserves attention. NAF is an intraductal mammary physiological fluid and represents a source of many biomarkers including miRNAs ( 102 ). A number of advantages including its obtainability in the majority of women, the origin of BC, simplicity, and non-invasiveness of sampling, make it a valuable source of miRNAs and LB target in BC diagnosis ( 102 , 103 ).…”

Patient-centered research: how do women tolerate nipple fluid aspiration as a potential screening tool for breast cancer?

“…A speci c liquid biopsy of the breast is nipple aspirate uid (NAF), a bio uid that accumulates at small amounts in the breast ducts of non-lactating women (14). As such, it can provide information about the breast microenvironment and its subtle changes.…”

“…Therefore, efforts focus on the development of tools beyond current imaging-based screening. In that context, liquid-based biomarkers for early detection of breast cancer are being investigated as these have the potential to be implemented as an add-on or triage tool in the early detection workup (14). Liquid-biopsy based screening holds promise as it allows repeated sampling by non-invasive means with potential high accuracy, simple and fast interpretation at low costs (15,16).…”

Patient-centered research: how do women tolerate nipple fluid aspiration as a potential screening tool for breast cancer?

“…Therefore, efforts focus on the development of tools beyond current imaging-based screening. In that context, liquid-based biomarkers for early detection of breast cancer are being investigated as these have the potential to be implemented as an add-on or triage tool in the early detection workup [ 14 ]. Liquid-biopsy based screening holds promise as it allows repeated sampling by non-invasive means with potential high accuracy, simple and fast interpretation at low costs [ 15 , 16 ].…”

“…A specific liquid biopsy of the breast is nipple aspirate fluid (NAF), a biofluid that accumulates at small amounts in the breast ducts of non-lactating women [ 14 ]. As such, it can provide information about the breast microenvironment and its subtle changes.…”