Devices and methods for obtaining mammary fluid samples for evaluating breast diseases, including cancer

Abstract

Biological samples of mammary fluid or components thereof are obtained using a breast pump device coupled with a solid phase sample collection medium, alternatively facilitated by administering oxytocin to the subject. The breast pump device stimulates expression of mammary fluid and provides for collection of diagnostic samples to evaluate breast disease, including cancer. The biological sample may include whole cells or cellular components, purified or bulk proteins, glycoproteins, peptides, nucleotides or other desired constituents comprising a breast disease marker. Methods, kits and adapter devices relating to the breast pump device are also provided. Yet additional methods, devices, accessories, and materials are provided for laboratory handling and processing of breast fluid samples and for related diagnostic methods.

Description

RELATED APPLICATIONS [0001] This application claims the priority benefits of U.S. Provisional Patent Application No. 60 / 248,134, filed by Quay on Nov. 13, 2000 and U.S. Provisional Patent Application No. 60 / 248,136, filed by Quay on Nov. 13, 2000. The disclosures of each of the foregoing priority applications are incorporated herein by reference in their entirety.TECHNICAL FIELD OF INVENTION [0002] The invention relates to methods, devices, and kits for obtaining and assaying biological samples from mammary fluid. More specifically, the invention relates to methods, devices, and kits for obtaining and assaying fluid and cytological samples from the mammary glands of a mammalian subject for evaluating, diagnosing and managing breast disease, including infections, pre-cancerous conditions, cancer susceptibility and cancer. BACKGROUND OF THE INVENTION [0003] Breast cancer is by far the most common form of cancer in women, and is the second leading cause of cancer death in humans. Despi...

AI Technical Summary

Benefits of technology

[0026] According to these methods, operation of the pump results in an expressed breast fluid sample contacting the solid phase sample collection medium, typically while the pump remains applied to the breast. Within the foregoing methods, additional methods are provided which employ a novel, hand-held breast pump device, wherein a doctor, technician or patient collecting a breast fluid specimen can grasp and operate the hand-held pump to stimulate expression of breast fluid and collect a specimen thereof while keeping one hand free for additional tasks. The compact hand-held pump design allows the device to be picked up and manipulated with one hand, to seat the breast engaging element against the breast, apply vacuum pressure to the breast by manual operation of the vacuum pump to cause a suitable volume of breast fluid to be expressed at or near the nipple, and to simultaneously collect at least a primary sample of expressed breast fluid onto, or within, the solid phase sample collection medium without additional manual steps or a need to remove the device from the breast or engage two hands in the operation.

[0029] In relation with these methods, various sample collection devices and accessories for use therewith are provided within more detailed embodiments of the invention. Typically, breast fluid collection devices of the invention include a breast engaging member constructed of a non-porous material that is sized and dimensioned to receive at least a nipple portion of a human breast and form a suction seal therewith. One or more solid phase sample collection media are provided in fluid connection with the breast engaging member for receiving a sample of expressed breast fluid. A vacuum pump mechanism is provided in gaseous connection with the breast engaging member for generating negative pressure through the breast engaging member to facilitate breast fluid expression.

[0032] In other detailed embodiments of the invention, the sample collection device is a hand-held breast pump incorporating the breast engaging member and the vacuum pump mechanism in a compact, structurally integrated breast fluid collection apparatus suitable for manipulation and operation using only one hand. In certain embodiments, hand-held breast pump comprises a modular device made up of a plurality of components, each joined or securable in fixed structural interconnection with one another and capable of partial or complete disassembly from remaining components to facilitate operation, cleaning, servicing and / or storage of the device. The modular breast pump can include, for example, a separate breast engaging member detachable from one or more interconnecting components of the device for cleaning or to allow interchanging of different engaging members to accommodate breast anatomy differences among patients.

Problems solved by technology

All too often, breast cancer is discovered at a stage that is too far advanced, when therapeutic options and survival rates are severely limited.

In addition to the problem of early detection, there remain serious problems in distinguishing between malignant and benign breast disease, in staging known breast cancers, and in differentiating between different types of breast cancers (e.g. estrogen dependent versus non-estrogen dependent tumors).

Previously, many cancer markers could only be detected or measured using conventional biochemical assay methods, which generally require large test samples and are therefore unsuitable in most clinical applications.

For the purpose of breast cancer evaluation, the use of conventional or needle biopsy samples for cancer marker assays is often undesirable, because a primary goal of such assays is to detect the cancer before it progresses to a palpable or mammographically detectable tumor stage.

Prior to this stage, biopsies are generally contraindicated, making early screening and low risk monitoring procedures employing such samples untenable.

Efforts to utilize serum samples for breast cancer marker assays have met with limited success, largely because the targeted markers are either not detectable in serum, or because telltale changes in the levels or activity of the markers cannot be monitored in serum.

In addition, the presence of breast cancer markers in serum probably occurs at the time of micro-metastasis, making serum assays less useful for detecting pre-metastatic disease.

Although the evaluation of mammary fluid has been shown to be a useful method for screening nonpalpable breast cancer in women who experience spontaneous nipple discharge, the rarity of this condition renders the methods of Inaji et al, inapplicable to the majority of women who are candidates for early breast cancer screening.

It is likely that other antibodies used to assay other cancer markers may exhibit even lower sensitivity than the anti-CEA antibodies used by Inaji and coworkers, and may therefore not be adaptable or sensitive enough to be employed even in dry chemical immunoassays of small samples of spontaneously discharged mammary fluid.

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