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 The first time Charity Ramsey heard about ductal lavage, a new technique to assess a woman's risk of breast cancer, the 27-year-old thought it would be the future of breast cancer -- but not a test she would need for years.

 The second time she heard about the procedure, it was from her doctor, who recommended it as a way to discern why she was experiencing discharge from one of her breasts.

 For women who have a risk of breast cancer, Ramsey discovered, the future is now.

 Ductal lavage examines cells from inside the milk ducts, where most breast cancers originate. The cells are put under a microscope to check for abnormalities, which could be a precursor to cancer. 

``Anybody who has to deal with high-risk women will find lavage useful because it deals with information you can't get anywhere else today,'' said Dr. David Hung, a medical oncologist and chief executive officer of Pro-Duct Health, the Menlo Park, Calif., company that markets the equipment for the test, which generally takes between half an hour to an hour. 

Only about 70 doctors in the United States perform the test, but the company expects to train many more. Ramsey, a Hollywood resident, went to Dr. Robert Donoway, the only doctor in South Florida offering the test. Company officials said the test has just started to become available across the country. 

In May, Donoway, a surgical oncologist, performed the test for the first time on a handful of women, including Ramsey, at Hollywood Medical Center.

 Ramsey had a mammogram and MRI. Both were negative -- good news. But her maternal grandmother died of breast cancer and her mother had a problem with benign lumps. So now she's awaiting results from the ductal lavage. 

``I think it's all going to be OK, but I have symptoms that were questionable,'' said Ramsey, who's studying at Barry University to be a physician's assistant. ``I just wanted to be extra sure.''

 Doctors also view the test as an additional and sometimes crucial source of information as to a woman's chance of developing breast cancer. Not intended as a replacement for mammograms, ductal lavage is a noninvasive procedure that looks at what's going on inside the breast. 

``It offers an additional screening component for the high-risk patient,'' Donoway said. ``It can better direct the route of care.

'' About five million women in the United States at risk of breast cancer will be candidates for the procedure, the company estimates. The cost is not covered by insurance and some doctors like Donoway determine the fee on a case by case basis. In other parts of the country it can run between $400 and $800, depending on the case.

 The process can be done in a doctor's office. Donoway has been performing the procedure in the Breast Care Center at Hollywood Medical Center. 

First the doctor uses a topical anesthetic on the nipple and applies suction pressure to bring the fluid to the surface and identify the duct's location. Then the doctor inserts a tiny catheter into the duct and injects an anesthetic followed by saline fluid -- the lavage or washing part of the procedure. Then the doctor draws out a sample, which will contain ductal cells. 

All told, the process is not particularly painful, said Lisa Stevens, one of Donoway's first patients to have the test. She defined the sensation as being similar to that of milk coming in during breast feeding. ``It's a real fullness feeling,'' she said. She felt a bit uncomfortable when the catheter was inserted and was a little sore for a day or two. 

Stevens, who has been watching a lump in her breast, figured the test could only help. ``I've followed the lump for three years, and this was just the natural progression,'' Stevens said.

 Soon, she should have the results. A California laboratory checks her sample and those of other women who have had the test to detect any abnormalities. Within a few weeks the results are sent to the doctor.

Theoretically speaking, the process is similar to the Pap smear, in which cervical cells are examined under a microscope to look for changes that could signal cancer. 

Ductal lavage offers similar information. ``Now you have the opportunity to identify is it bland, is there something abnormal that warrants a biopsy or is it something that's truly cancerous?'' Donoway said. 

After reviewing the results, women whose cells indicate they are at high risk of developing breast cancer may opt to take drugs that can reduce that chance. Because these drugs carry adverse side effects, the more information the better, said Hung of Pro-Duct Health.

 ``If you can identify women with the highest risks, hopefully the benefits will outweigh the risks,'' Hung said. ``Anybody who has to deal with high-risk women will find lavage useful because it deals with information you can't get anywhere else today.''