EDITORIALS Ductal Lavage for Early Detection—What Doesn’t Come

Early detection via screening mammography has played a major role in the declining breast cancer mortality rates over the past decade (1,2). The impact of screening mammography on mortality rates is less for women younger than 50 years because of a lower test sensitivity and a lower rate of breast cancer (3–5). Sensitivity for detection of breast cancer in general screening populations has been reported as 61%–81 % for women aged 40–49 years (5) and 87 % for women aged 50–64 years (6). The lower sensitivity is in turn attributed to higher breast density in younger women (7). Unfortunately, women at increased risk of breast cancer by virtue of having a family history of breast cancer, proliferative breast disease with or without atypia, or use of hormone replacement therapy with both estrogen and proges-tin are those most likely to have dense breasts (8–11). Sensitiv-ity was recently reported to be only 33 % in a group of 190