Frequency dynamics of a chain of magnetized rotors: dumbbell model vs Landau-Lifshitz equation.

During the past decades magnetic materials and structures that span several length scales have been of interest mainly due to their application in data storage and processing, flexible electronics, medicine, between others. From a microscopic point of view, these systems are typically studied using the Landau-Lifshitz equation (LLE), while approaches such as the dumbbell model are used to study macroscopic magnetic structures. In this work we use both the LLE and the dumbbell model to study spin chains of various lengths under the effect of a time dependent-magnetic field, allowing us to compare qualitatively the results obtained by both approaches. This has allowed us to identify and describe in detail several frequency modes that appear, with additional modes arising as the chain length increases. Moreover, we find that high frequency modes tend to be absorbed by lower frequency ones as the amplitude of the field increases. The results obtained in this work are of interest not only to better understand the behavior of the macroscopic spins chains, but also expands the available tools for qualitative studies of both macroscopic and microscopic versions of the studied system, or more complex structures such as junctions or lattices. This would allow to study the qualitative behavior of microscopic systems (e.g. nanoparticles) using macroscopic arrays of magnets, and vice versa.

Cystoid Macular Edema after an uncomplicated Gonioscopy- Assisted Transluminal Trabeculotomy on a previously vitrec- tomized patient.

Purpose: The main purpose of this study was to report a case of cystoid macular edema (CME) after gonioscopy-assisted transluminal trabeculotomy (GATT). Methods: We describe the case of a 73-year-old woman with ocular hypertension and history of cataract surgery combined with posterior vitrectomy and epiretinal membrane peeling 2 years before, who developed CME after uncomplicated GATT procedure. Results: Uneventful GATT surgery was performed in an eye with ocular hypertension. A month after GATT surgery, the patient com-plained of blurry vision. Best corrected visual acuity had deteriorated from 20/20 on Snellen chart, to 20/70. The patient was diagnosed with CME. Treatment with topical non-steroidal anti-inflammatory drug (NSAID) and topical corticosteroids for one month, and oral carbonic anhydrase inhibitor for one week achieved a total CME regression with recovery of a normal macular and foveal architecture. Conclusions: Surgery-induced CME may occur following stand-alone microinvasive glaucoma surgery (MIGS) such as GATT. It would be worthwhile to conduct studies to explore whether the prophylactic use of NSAID and corticosteroids is justified.

Plasma rich in growth factors as treatment for a full-thickness macular hole due to macular telangiectasia type 2.

Full-thickness macular hole is a rare complication of macular telangiectasia type 2, and its treatment is still controversial. A patient with a full-thickness macular hole secondary to macular telangiectasia type 2 underwent vitreoretinal surgery with a plasma rich in growth factors membrane in the macular hole. At the sixth month of follow-up, anatomical and functional improvements were achieved, with no adverse effects. Plasma rich in growth factors is a new option, with advantages due to its biological properties that achieves good results in terms of safety and effectiveness in the surgical treatment of macular hole.

Plasma rico en factores de crecimiento como tratamiento para agujero macular de espesor total secundario a telangiectasia macular tipo 2 / Plasma rich in growth factors as treatment for a full-thickness macular hole due to macular telangiectasia type 2

El agujero macular de espesor total es una complicación rara de la telangiectasia macular tipo 2, y su tratamiento es aún controvertido. Una paciente con esta entidad fue llevada a cirugía vitreorretiniana con aplicación de membrana de plasma rico en factores de crecimiento sobre el agujero macular. Al sexto mes de cirugía se logró mejoría anatómica y funcional, sin efectos adversos asociados. El plasma rico en factores de crecimiento es una alternativa nueva en el tratamiento quirúrgico del agujero macular atípico y/o persistente, que logra buenos resultados en términos de seguridad efectividad, debido a sus propiedades biológicas (AU)

Full-thickness macular hole is a rare complication of macular telangiectasia type 2, and its treatment is still controversial. A patient with a full-thickness macular hole secondary to macular telangiectasia type 2 underwent vitreoretinal surgery with a plasma rich in growth factors membrane in the macular hole. At the sixth month of follow-up, anatomical and functional improvements were achieved, with no adverse effects. Plasma rich in growth factors is a new option, with advantages due to its biological properties that achieves good results in terms of safety and effectiveness in the surgical treatment of macular holey (AU)

Equilibrium and symmetries of altitudinal magnetic rotors on a circle.

Macroscopic magnets can easily be manipulated and positioned so that interactions between themselves and with external fields induce interesting dynamics and equilibrium configurations. In this work, we use rotating magnets positioned in a line or at the vertices of a regular polygon. The rotation planes of the magnets can be modified at will. The rich structure of stable and unstable configurations is dictated by symmetry and the side of the polygon. We show that both symmetric solutions and their symmetry-breaking bifurcations can be explained with group theory. Our results suggest that the predicted magnetic textures should emerge at any length scale as long as the interaction is polar, and the system is endowed with the same symmetries.

Resultados en el corto y mediano plazo del tratamiento endovascular en la enfermedad arterial obstructiva infrapoplítea en pacientes con isquemia crítica de una extremidad / Short to midterm results after endovascular approach in critical limb isquemia in patients with below-the-knee arterial disease

Resumen Objetivo: Mostrar los resultados en el corto y mediano plazo del tratamiento endovascular de angioplastia transluminal percutánea (ATP) con balón en pacientes en estado de isquemia crítica por enfermedad arterial obstructiva infrapoplítea. Materiales y Método: Estudio descriptivo, observacional, retrospectivo. Se incluyeron los pacientes hospitalizados entre 2009 y 2018 por isquemia crítica Fontaine III o IV sometidos a una ATP del territorio infrapoplíteo. Se observó como objetivos primarios la preservación de la extremidad afectada y la mortalidad posoperatoria a un año plazo, y como objetivos secundarios los procedimientos adicionales en pacientes con lesiones o necrosis distales, estadía hospitalaria, complicaciones posoperatorias y necesidad de reintervención. Resultados: Se incluyeron 42 pacientes con un promedio de edad de 66 años (46-82), con importantes comorbilidades. Un 83,3% ingresó en etapa Fontaine IV. En 16 casos se realizó una angioplastia percutánea en más de una arteria. No se colocó stents. Se presentaron complicaciones en 3 pacientes, 2 requirieron una amputación mayor y en otro se debió efectuar un nuevo procedimiento endovascular de rescate. La estadía hospitalaria promedio fue 22 días. No hubo mortalidad precoz posprocedimiento. La mortalidad global a un año fue 9,5%. A todos los pacientes en etapa Fontaine IV se les efectuó algún procedimiento adicional, a 31 una amputación menor, 3 cerraron sus lesiones por segunda intención y en otro se realizó un injerto dermo-epidérmico. De los 35 pacientes con seguimiento, 77% preservó su extremidad a un año. Conclusión: La reparación endovascular mediante una angioplastia percutánea en estos casos es un procedimiento seguro y tiene una alta tasa de preservación de la extremidad inicial a un año de seguimiento.

Aim: Show initial and midterms results of endovascular Percutaneous Transluminal Angioplasty (PTA) in critical limb isquemia (CLI) patients caused by below-the-knee arterial disease. Materials and Method: Observational, descriptive and retrospective study. 42 CLI patients admitted in our hospital from 2009 until 2018 with Fontaine III or IV treated by PTA in infrapopliteal arteries were analyzed, collecting demographic, clinical and surgical characteristics, additional procedures in Fontaine IV, hospital stay, postoperative complications, need of reintervention, limb preservation and mortality with one year follow-up after procedure. Results: 42 patients, average age 66 year-old (46-82), with significant comorbidities. Fontaine IV stage patients were 83.3%. In 16 cases more than one artery was intervened. No stent revascularization was performed. Complications occurred in 3 patients, 2 required major amputation and an urgent endovascular reintervention was required in another. Average hospital stay was 22 days with no post-operative mortality. One-year global mortality was 9.5 One-year follow-up in 35 patients shows that 77% preserved their limb. Conclusión: Percutaneous transluminal angioplasty procedure in this patients has a high rate of limb preservation in a one-year follow-up. There was no post-operative mortality.

Plasma rich in growth factors as treatment for a full-thickness macular hole due to macular telangiectasia type 2. / Plasma rico en factores de crecimiento como tratamiento para agujero macular de espesor total secundario a telangiectasia macular tipo 2.

Full-thickness macular hole is a rare complication of macular telangiectasia type 2, and its treatment is still controversial. A patient with a full-thickness macular hole secondary to macular telangiectasia type 2 underwent vitreoretinal surgery with a plasma rich in growth factors membrane in the macular hole. At the sixth month of follow-up, anatomical and functional improvements were achieved, with no adverse effects. Plasma rich in growth factors is a new option, with advantages due to its biological properties that achieves good results in terms of safety and effectiveness in the surgical treatment of macular hole.

2018 consensus statement by the Spanish Society of Pathology and the Spanish Society of Medical Oncology on the diagnosis and treatment of cancer of unknown primary

Cancer of unknown primary (CUP) is defined as a heterogeneous group of tumours that present with metastasis, and in which attempts to identify the original site have failed. They differ from other primary tumours in their biological features and how they spread, which means that they can be considered a separate entity. There are several hypotheses regarding their origin, but the most plausible explanation for their aggressiveness and chemoresistance seems to involve chromosomal instability. Depending on the type of study done, CUP can account for 2-9% of all cancer patients, mostly 60-75 years old. This article reviews the main clinical, pathological, and molecular studies conducted to analyse and determine the origin of CUP. The main strategies for patient management and treatment, by both clinicians and pathologists, are also addressed

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2018 consensus statement by the Spanish Society of Pathology and the Spanish Society of Medical Oncology on the diagnosis and treatment of cancer of unknown primary.

Cancer of unknown primary (CUP) is defined as a heterogeneous group of tumours that present with metastasis, and in which attempts to identify the original site have failed. They differ from other primary tumours in their biological features and how they spread, which means that they can be considered a separate entity. There are several hypotheses regarding their origin, but the most plausible explanation for their aggressiveness and chemoresistance seems to involve chromosomal instability. Depending on the type of study done, CUP can account for 2-9% of all cancer patients, mostly 60-75 years old. This article reviews the main clinical, pathological, and molecular studies conducted to analyse and determine the origin of CUP. The main strategies for patient management and treatment, by both clinicians and pathologists, are also addressed.

Caracterización del acto homicida según los informes de autopsias realizados por el servicio médico legal de Concepción, periodo 2011-2015 / Characterization of the homicidal act according to the autopsy reports released by the Legal Medical Service of Concepción, 2011-2015

Introducción: Más de la tercera parte de los homicidios reportados a nivel mundial tienen lugar en el continente Americano, siendo Chile uno de los países con las tasas más bajas de Latinoamérica. Actualmente, son escasos los estudios que caracterizan el acto homicida en nuestro país. Se caracterizó el acto homicida según las autopsias realizadas por el Servicio Médico Legal (SML) de Concepción, durante el periodo 2011-2015. Materiales y método: Se realizó un estudio transversal de informes de autopsia con causa homicidio durante los años 2011 a 2015, realizadas por el SML de Concepción, utilizándose las variables: género, edad, procedencia, lugar de ocurrencia del homicidio, estado civil, ocupación, patologías asociadas, causa de muerte, tipo de arma utilizada, alcoholemia, examen toxicológico y atención en centro asistencial. El estudio fue aprobado por comité de ética. Resultados: Del total de autopsias en el periodo 2011-2015; 5.92% (241) correspondieron a homicidios, de los cuales un 89.6% fueron víctimas de sexo masculino. Del total de homicidios estudiados la edad promedio fue de 33 años, un 58.3% del total ocurrieron en vía pública y 42.1% fallecieron por trauma torácico complicado. Finalmente del total de homicidios, un 49,2% poseían alcoholemia negativa y 49.2% examen toxicológico negativo. Discusión: En Chile, el homicidio afecta a una pequeña porción de la población, acercándose a las bajas tasas que presentan diversos países de Europa. En su mayoría, los homicidios reportados fueron hombres entre los 18 y 29 años de edad, resultado similar a lo descrito a nivel mundial.

Introduction: More than a third part of the worldwide reported homicides takes place in the whole american continent, and Chile is one the countries with the lowest rates in latin america. Only a few are the studies that characterize the homicidal act in our country. Characterize the homicide act according to the autopsies reports performed by the Legal Medical Service (SML) of Concepción, during the period 2011-2015. Materials and methods: We made a transversal study with the autopsies reports classified as homicide, performed by the SML Concepción, between the years 2011 and 2015 using variables such as: gender, age, place of residence, place of homicidal act, marital state, occupation, comorbidities, death cause, weapon, blood alcohol concentration, toxicological results and medical assistance. An ethic committee approved the study. Results: From the total autopsies between 2011 and 2015; 5.92% (241) were homicides, of which 89.4% were men. The average age of homicides victims was 33 years old, 58.3% occurred on public areas and 42.1% were died because a complicated thoracic traumatism. And finally from the total homicides, 49.2% had none alcohol in blood such as the 49.2% as well had negative toxicological test. Discussion: In Chile, homicide affects a few number of its population, approaching the low rates that some european countries have. The most of the homicides reported were men between 18 to 29 years old, similar results comparing with the worldwide statistics.

Effect of gamma irradiation on phenol content, antioxidant activity and biological activity of black maca and red maca extracts (Lepidium meyenii walp).

This study was performed to determine the effects of gamma irradiation on UV spectrum on maca, total content of polyphenols, 1,1-diphenyl-2-picrylhydrazyl (DPPH) radical-scavenging activities and in vivo biological activities of red and black maca extracts (Lepidium meyenii). Adult mice of the strain Swiss aged 3 months and weighing 30-35 g in average were used to determine biological activities. Daily sperm production, effect on testosterone-induced prostate hyperplasia and forced swimming test were used to determine the effect of irradiation on biological activities of maca extracts. Irradiation did not show differences in UV spectrum but improves the amount of total polyphenols in red maca as well as in black maca extracts. In both cases, black maca extract has more content of polyphenols than red maca extract (p < 0.01). Gamma irradiation significantly increased the antioxidant capacity (p < 0.05). No difference was observed in daily sperm production when irradiated and nonirradiated maca extract were administered to mice (p > 0.05). Black maca extract but not red maca extract has more swimming endurance capacity in the forced swimming test. Irradiation of black maca extract increased the swimming time to exhaustion (p < 0.05). This is not observed with red maca extract (p > 0.05). Testosterone enanthate (TE) increased significantly the ventral prostate weight. Administration of red maca extract in animals treated with TE prevented the increase in prostate weight. Irradiation did not modify effect of red maca extract on prostate weight (p > 0.05). In conclusion, irradiation does not alter the biological activities of both black maca and red maca extracts. It prevents the presence of microorganisms in the extracts of black or red maca, but the biological activities were maintained.

Biomarker testing in advanced non-small-cell lung cancer: a National Consensus of the Spanish Society of Pathology and the Spanish Society of Medical Oncology

In 2011, the Spanish Society of Medical Oncology and the Spanish Society of Pathology started a joint project to establish recommendations on biomarker testing in patients with advanced non-small-cell lung cancer based on the current evidence. Most of these recommendations are still valid, but new evidence requires some aspects to be updated. Specifically, the recommendation about which biomarkers to test in which patients is being amended, and the best way to manage tumour samples and minimum requirements for biomarker test material are defined. Suitable techniques for testing for epidermal growth factor receptor mutations and anaplastic lymphoma kinase rearrangement are also reviewed, and a consensus is reached on which situations warrant re-biopsy (AU)

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Biomarker testing in advanced non-small-cell lung cancer: a National Consensus of the Spanish Society of Pathology and the Spanish Society of Medical Oncology.

In 2011, the Spanish Society of Medical Oncology and the Spanish Society of Pathology started a joint project to establish recommendations on biomarker testing in patients with advanced non-small-cell lung cancer based on the current evidence. Most of these recommendations are still valid, but new evidence requires some aspects to be updated. Specifically, the recommendation about which biomarkers to test in which patients is being amended, and the best way to manage tumour samples and minimum requirements for biomarker test material are defined. Suitable techniques for testing for epidermal growth factor receptor mutations and anaplastic lymphoma kinase rearrangement are also reviewed, and a consensus is reached on which situations warrant re-biopsy.

Expression profiling of breast tumors based on human epidermal growth factor receptor 2 status defines migration-related genes.

OBJECTIVE: Breast cancer is a heterogeneous neoplasm. Distinct subtypes of breast cancer have been defined, suggesting the existence of molecular differences contributing to their clinical outcomes. However, the molecular differences between human epidermal growth factor receptor 2 (HER2)-positive and HER2-negative breast cancer tumors remain unclear. The aim of this study was to identify a gene expression profile for breast tumors based on their HER2 status. METHODS: The HER2 status was determined by immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH) in 54 breast tumor samples. Using Affymetrix microarray data from these breast tumors, we established the expression profiling of breast cancer based on HER2 IHC and FISH results. To validate microarray experiment data, real-time quantitative reverse transcription-PCR was performed. RESULTS: We found significant differences between the HER2-positive and HER2-negative breast tumor samples, which included overexpression of HER2, other genes located on 17q12 and genes functionally related to migration. CONCLUSION: Our study shows the potential of integrated genomic profiling to shed light on the molecular knowledge of HER2-positive breast tumors.

Biomedical application of fuzzy association rules for identifying breast cancer biomarkers.

Current breast cancer research involves the study of many different prognosis factors: primary tumor size, lymph node status, tumor grade, tumor receptor status, p53, and ki67 levels, among others. High-throughput microarray technologies are allowing to better understand and identify prognostic factors in breast cancer. But the massive amounts of data derived from these technologies require the use of efficient computational techniques to unveil new and relevant biomedical knowledge. Furthermore, integrative tools are needed that effectively combine heterogeneous types of biomedical data, such as prognosis factors and expression data. The objective of this study was to integrate information from the main prognostic factors in breast cancer with whole-genome microarray data to identify potential associations among them. We propose the application of a data mining approach, called fuzzy association rule mining, to automatically unveil these associations. This paper describes the proposed methodology and illustrates how it can be applied to different breast cancer datasets. The obtained results support known associations involving the number of copies of chromosome-17, HER2 amplification, or the expression level of estrogen and progesterone receptors in breast cancer patients. They also confirm the correspondence between the HER2 status predicted by different testing methodologies (immunohistochemistry and fluorescence in situ hybridization). In addition, other interesting rules involving CDC6, SOX11, and EFEMP1 genes are identified, although further detailed studies are needed to statistically confirm these findings. As part of this study, a web platform implementing the fuzzy association rule mining approach has been made freely available at: http://www.genome2.ugr.es/biofar .

Guidelines for biomarker testing in advanced non-small-cell lung cancer. A national consensus of the Spanish Society of Medical Oncology (SEOM) and the Spanish Society of Pathology (SEAP)

Patients with advanced non-small-cell lung cancer (NSCLC) carrying epidermal growth factor receptor (EGFR) mutations can now have specific treatment based on the result of biomarker analysis and patients with rearrangements of the anaplastic lymphoma kinase (ALK) gene will probably soon be able to. This will give them better quality of life and progression-free survival than conventional chemotherapy. This consensus statement was conceived as a joint initiative of the Spanish Society of Medical Oncology (SEOM) and the Spanish Society of Pathology (SEAP), and makes diagnostic and treatment recommendations for advanced NSCLC patients based on the scientific evidence on biomarker use. It therefore provides an opportunity to improve healthcare efficiency and resource use, which will undoubtedly benefit these patients. Although this field is in continuous evolution, at present, with the available data, this panel of experts recommends that all patients with advanced NSCLC of non-squamous cell subtype, or non-smokers regardless of the histological subtype, should be tested for EGFR gene mutations within a maximum of 7 days from the pathological diagnosis. Involved laboratories must participate in external quality control programmes. In contrast, ALK gene rearrangements should only be tested in the context of a clinical trial, although the promising data obtained will certainly justify in the near future its routine testing in patients with no EGFR mutations. Lastly, routine testing for other molecular abnormalities is not considered necessary in the current clinical practice (AU)

Cinética de la proteína C reactiva y procalcitonina en el postoperatorio de la escoliosis / Kinetics of C-reactive protein and procalcitonin after scoliosis surgery

Introducción. El síndrome de respuesta inflamatoria sistémica que se desencadena tras distintos tipos de cirugía condiciona una elevación en los niveles de proteína C reactiva (PCR) y procalcitonina (PCT) que puede limitar su valor para el diagnóstico de una infección postoperatoria. El objetivo del estudio es describir la cinética de ambas tras la cirugía de escoliosis. Métodos. Estudio prospectivo observacional desarrollado en una Unidad de Cuidados Intensivos Pediátricos de8 camas de un hospital universitario. Se incluyeron 29 niños. Se analizaron los niveles de PCR y PCT a las 0, 24, 48 y 72horas del postoperatorio de la escoliosis. Resultados. La PCT se elevó precozmente con un pico máximo a las 24 horas (media: 0,41 ng/ml; IC 95%: 0,11-0,71ng/ml) y se mantuvo por debajo de los puntos de corte para infección localizada y sepsis, establecidos en nuestra Unidad (0,79 y 1,80 ng/ml respectivamente). La proteína C reactiva se elevó más tardíamente, alcanzando su pico a las 48horas (media: 12,23 mg/dl; IC 95%: 5,61-18,86 mg/dl) y superando los puntos de corte para sepsis e infección localizada (5,7 y 6,45 mg/dl respectivamente) establecidos en nuestra unidad. Conclusiones. La PCT, debido a su elevación más precoz manteniéndose por debajo de 0,5 ng/ml, se perfila como una herramienta más fiable que la PCR para el diagnóstico de infección en el postoperatorio de la escoliosis (AU)

Introduction. Post-surgery systemic inflammatory response syndrome leads to an elevation in C reactive protein (CRP) and procalcitonin (PCT) levels which may impedet heir diagnostic value for postoperative infection. The aim of this study is to establish the kinetics of both markers after scoliosis surgery. Methods. Prospective observational study setting in an eight-bed pediatric intensive care unit of a university hospital. Twenty-nine children were included. CRP and PCT levels were determined at 0, 24, 48 y 72 h after scoliosis surgery. Results. PCT levels increased early after surgery with a maximum peak at 24 hours (mean: 0.41 ng/ml; IC 95% 0.11-0.71 ng/ml) that is below the cutoff values for local infection or sepsis diagnosis (0.79 and 1.8 ng/ml respectively)previously established in our pediatric intensive care unit. However, C reactive protein increased later, reached the higher peak at 48 hours (mean: 12.23 mg/dl IC 95% 5.61-18.86 mg/dl) that is above cutoff values for sepsis and local infection (5.7 and 6.45 mg/dl respectively) previously established in our pediatric intensive care unit Conclusion. Procalcitonin seems to be a more reliable diagnosis tool of postoperative scoliosis infection due to its earlier elevation and the maintenance of its levels below the cut-off value for infection (AU)

Consensus of the Spanish Society of Medical Oncology (SEOM) and Spanish Society of Pathology (SEAP) for HER2 testing in gastric carcinoma

The identification of HER2 alterations in advanced gastric carcinomas is of critical importance in daily clinical practice as such neoplasms require specific treatment with trastuzumab. For these reasons, pathologists and oncologists with expertise in gastric carcinomas and HER2 testing from both organisations (SEAP and SEOM) have endeavoured to discuss and agree on national guidelines for HER2 testing in gastric carcinomas. These guidelines are based on the experience of those who participated in the discussions and also on experience published internationally. These agreed guidelines give the minimum requirements that a pathological anatomy laboratory must fulfil in order to guarantee adequate HER2 testing in daily practice. Any laboratories which do not meet the minimum standards set out in the guidelines must make every effort to achieve compliance (AU)

Update on the diagnosis of cancer of unknown primary (CUP) origin

The cancer of unknown primary (CUP) concept encompasses a heterogeneous group of cancers that are difficult to diagnose and that show diverse clinical and histopathological features. Currently, CUP is the fifth most frequent cancer diagnosis in women and the eighth in men. The ongoing development of new therapies specific to the various cancer types makes mandatory the identification of the primary tumour in CUP patients, so that they may benefit from advances in therapy and improvements in prognosis. Molecular detection techniques provide very useful tools in the prediction of primary tumour types and must be used together with clinical, histopathological and IHC diagnostic techniques. Steady collaboration and fluid communication between oncologists and pathologists is of the utmost importance for the correct interpretation of tests and the personalised approach required by each individual case. Work in multidisciplinary teams will result in significant changes in the diagnosis and treatment of these patients (AU)

HER2 status in breast cancer: experience of a Spanish National Reference Centre

BACKGROUND: Accurate HER2 testing is of great clinical value for the identification of breast cancer patients who are eligible for trastuzumab therapy. The aim of this study is to review breast carcinomas diagnosed from 2001 to 2007 at a Spanish National Reference Centre for HER2 testing, evaluating the agreement between HER2 immunohistochemical (IHC) tests and fluorescence in situ hybridisation (FISH) tests. METHODS: Demographic and clinical information was obtained from 2751 breast carcinoma patients. HER2 IHC and FISH tests were performed both in a local laboratory and in the reference centre. The HER2 IHC0/1+, IHC2+, IHC3+ and FISH-positive patients comprised 64%, 20%, 16% and 24% of the available population, respectively (results from the reference centre). Using statistical approaches, we evaluated the agreement between: (1) HER2 IHC and FISH tests, and (2) results provided by the local and the reference laboratories. RESULTS: The data confirmed a statistically significant relation between HER2 overexpression and amplification. We also found that instances of polysomy 17 and heterogeneous patterns of HER2 expression (heterogeneous staining distribution in different areas of the same tumour) are more frequently observed in HER2-positive tumours. Finally, since the diagnoses were made from 2001 to 2007, we could also observe a rising agreement rate between laboratories/pathologists with time. CONCLUSIONS: HER2 testing is most accurate when performed by experienced pathologists and at a high-volume reference laboratory. Polysomy 17 and HER2 heterogeneous staining patterns should also be considered for a better understanding of the variation in the anti-HER2 therapeutic response (AU)