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  • 1
    ISSN: 1524-4741
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Overexpression of the Her-2/neu (HER2) oncogene is known to confer important prognostic and predictive value to patients with breast cancer. Controversy exists as to the best method for its determination caused primarily by the variable sensitivities of the different antibodies and interobserver differences, particularly in the group of breast cancers with borderline levels of expression of the protein product. This study was therefore designed to determine the status of the HER2 gene amplification in a group of breast carcinomas with low levels of overexpression. After an initial validation of our procedures, a series of 52 consecutive cases of formalin-fixed, paraffin-embedded breast cancers with low levels of overexpression and a series of 22 cases with no expression by immunohistochemistry were analyzed by fluorescence in situ hybridization (FISH), and the results correlated statistically. Amplification of the HER2 gene was observed in 16% of equivocal to weakly positive cases. Those that were amplified showed low levels of amplification with ratios less than 4.5 and a characteristic scattered pattern of distribution of HER2 signals in the FISH assay. In addition, heterogeneity was noted in two cases in the amplification of the HER2 gene within the same tumor samples with pockets of amplified tumor cells amidst nonamplified tumor cells. In cases without amplification, a statistically significant number showed chromosome 17 polysomy. In conclusion, equivocal to low levels of HER2 overexpression in breast cancers are associated, in the majority of cases, with chromosome 17 polysomy and a corresponding increase in the HER2 gene numbers. True gene amplification is present in only a minority of cases. FISH analysis should be used for confirmation of gene amplification. Prior screening and selection of appropriate immunohistochemistry-positive areas for FISH analysis may prove beneficial.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Boston, MA, USA : Blackwell Science Inc
    The @breast journal 5 (1999), S. 0 
    ISSN: 1524-4741
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: ▪ Abstract: The immunohistochemical staining patterns of type IV collagen (TIVC) and smooth muscle actin (SMA) were studied in benign and malignant breast lesions in order to assess their usefulness in the differential diagnosis of difficult lesions. Eighty-six in situ breast carcinomas (8 with microinvasion; 1 diagnosed after immunostaining) and 58 invasive carcinomas, with associated benign lesions including 87 nonproliferative fibrocystic changes, 19 sclerosing adenosis, 17 atypical hyperplasias, 7 benign papillary proliferations, 6 radial scars, and 105 normal mammary tissue, were studied. TIVC and SMA were concomitantly positive throughout in 94% of benign tissues, in 16% of in situ carcinomas, but in none of the invasive carcinomas. Conversely, both markers were negative in 66% of invasive carcinomas, but in none of the benign breast tissue and none of the in situ carcinomas. In 6% of the benign tissues, in 21% of in situ carcinomas, and in 34% of invasive carcinomas only one of the markers was positive. In the remaining 63% of the in situ carcinomas there were discontinuities of the staining of both markers. It is therefore suggested that a diagnosis of invasive malignancy can be confirmed when both markers are negative, and ruled out when both markers are positive. This is particularly useful, in our experience, in the identification of small foci of invasion. The stains are useful when used in parallel, whereas they may be misleading when used singly. The staining pattern is not useful in the differential diagnosis of atypical hyperplasia and in situ carcinoma. ▪
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Science Inc
    The @breast journal 10 (2004), S. 0 
    ISSN: 1524-4741
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract:  Sentinel lymphadenectomy is a sensitive and specific procedure that has reduced the need for complete axillary lymph node dissections in patients with negative sentinel lymph nodes (SLNs). However, numerous studies have shown that SLN may be the only positive lymph node in 40 to 70% of cases. This study was therefore undertaken to determine if the characteristics of primary breast tumor or its metastasis in the SLN could predict the presence of residual disease in the nonsentinel lymph nodes (NSLNs) and thus allow for further reduction in axillary lymph node surgery. The SLN procedure was performed on 329 patients at our institution, of which 131 had positive SLNs and underwent further axillary surgery. Fifty-four patients had additional disease in the NSLNs, while in the remaining 77 cases, no residual disease was detected. The clinical and pathologic features of these cases were reviewed and statistical analysis was performed. Multivariate analysis determined two significant independent variables for prediction of residual disease in the axilla: the size of the metastatic tumor in SLNs and the presence of its extranodal extension. The mean tumor size in SLNs without residual disease in NSLNs was 0.4 cm. It was 1.1 cm in patients with additional NSLN metastasis. The positive predictive value in both instances is about 80%. The risk of NSLN involvement in patients with SLN tumors of ≤0.4 cm was 21%. The risk was the same (21%) for patients with micrometastatic disease (≤0.2 cm) in SLNs. In these cases the residual disease in the NSLNs was also small. SLNs with metastatic deposits larger than 1.0 cm were likely to contain additional metastases in the NSLNs in 81% of cases. This increased to 100% if the primary carcinoma was larger than 5 cm, if it was poorly differentiated, or if it showed HER-2/neu gene amplification. The presence of an extranodal extension of SLN metastasis was an independent predictor of residual axillary disease and was associated with NSLN metastasis in 76% of cases. Primary tumor characteristics did not correlate with the incidence of NSLN metastasis in our series. 
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Boston, MA, USA : Blackwell Science Inc
    The @breast journal 5 (1999), S. 0 
    ISSN: 1524-4741
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 5
    Electronic Resource
    Electronic Resource
    Boston, MA, USA : Blackwell Science Inc
    The @breast journal 5 (1999), S. 0 
    ISSN: 1524-4741
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 6
    ISSN: 1546-1718
    Source: Nature Archives 1869 - 2009
    Topics: Biology , Medicine
    Notes: [Auszug] The hallmark of Cowden disease (CD) [MIM 158350], also known as multiple hamartoma syndrome, is hamartomas of multiple organs, including skin, intestine, breast and the thyroid8. In addition to benign disease, breast cancers develop in approximately 30–50% of affected women and thyroid ...
    Type of Medium: Electronic Resource
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