Nipple Aspirate Fluid Collection, Related Factors and Relationship between Carcinoembryonic Antigen in Nipple Aspirate Fluid and Breast Diseases in Women in Harbin, PRC

This study aimed to examine the factors related to the ability to obtain nipple aspirate fluids in Chinese women and to evaluate the diagnostic value of carcinoembryonic antigen (CEA) in nipple aspiration fluids. Cross-sectional and case-control studies were used to examine the factors associated with the ability to obtain nipple aspiration fluids. A matched case-control study was used to explore the association of CEA level in nipple aspiration fluids with breast disease. CEA level was log(10)-transformed to normalize the distribution. Univariate and multivariate logistic regression were adopted to analyze the variables in relation to obtaining fluid and the association of its CEA levels and breast diseases. Receiver operating characteristic curve was used to evaluate the value of CEA levels for the detection of breast disease. The nipple aspiration fluid collection rate was 34.24% (201 of 587). Multivariate logistic regression analysis results showed the following to be significantly associated with a greater ability to obtain nipple aspiration fluids: earlier age at menarche [odds ratio (OR), 2.61; 95% confidence interval (95% CI), 1.15-5.91], lactating >12 months (OR, 2.28; 95% CI, 1.44-3.60), wet-type ear wax (OR, 3.80; 95% CI, 2.39-6.02), and fatty diet (OR, 1.56; 95% CI, 1.02-2.39). CEA levels in nipple aspiration fluids of cancerous breasts were significantly higher than those from breasts with benign disease and healthy controls (OR(adj), 5.39; P < 0.01). However, the sensitivity of CEAs was 35.42% and the specificity was 85.42% whereas the CEA cutoff value was 307.61 ng/mL. The area under the receiver operating characteristic curve was 0.65. The nipple aspiration fluid collection rate in Chinese native women is lower compared to non-Asian-descendant women. CEA level does not seem to be a useful diagnostic tool for early cancer detection; it can only be used in conjugation with other methods. (Cancer Epidemiol Biomarkers Prev 2009;18(3):732-8)