Activating GNAS1 gene mutations in patients with premature thelarche.

OBJECTIVE: To identify GNAS1 gene mutations in girls with exaggerated and/or chronic fluctuating thelarche for at least 1-year duration with no other signs of precocious puberty, skeletal dysplasia, or typical skin lesions of McCune-Albright syndrome. STUDY DESIGN: We studied the GNAS1 gene mutation by allele-specific polymerase chain reaction and enzymatic digestion in leukocyte DNA in 23 girls previously described. RESULTS: Fluctuating thelarche was present in 14 girls and exaggerated thelarche was observed in 9. Molecular study revealed that 6 girls had a substitution of arginine by histidine in codon 201 (R201H [+]). Three R201H (+) girls reached their menarche at a mean chronologic age of 10.8 years and 9 of the R201H (-) girls at a mean age of 11 years. CONCLUSIONS: Activating mutations of GNAS1 gene may be observed in some girls with chronic fluctuating and/or exaggerated thelarche, without other classic signs of McCune-Albright syndrome.

bcl-2 Expression and apoptosis in primary and metastatic breast carcinomas.

OBJECTIVES: To evaluate the role of bcl-2 and apoptotic index in the progression from primary to metastatic breast carcinoma and their influence on prognosis. METHODS: bcl-2 expression was examined by immunohistochemistry and apoptotic index by in situ end-labelling in 116 surgical breast carcinomas and lymph node metastases from 50 patients. RESULTS: bcl-2 was observed in 69 cases (59.4%) of primitive carcinomas and 26 cases (65%) of metastatic breast carcinomas and there was agreement of bcl-2 expression between primary and metastatic sites except in 3 cases. bcl-2 expression was significantly associated with several favourable prognostic features, such as small tumour size (p = 0.03) and oestrogen and progesterone-receptor positivity (p < 0.01 and p < 0.001, respectively). A high apoptotic index was significantly associated with a number of poor prognostic factors, including poorly differentiated carcinomas, large tumour size, high Ki67 expression and high mitotic count (p < 0.001 in all cases). The mean apoptotic index was higher in lymph node metastasis than in primary carcinomas (1.19 vs. 0.69, p < 0.01). A low bcl-2 expression and a high apoptotic index were significantly associated with short-relapse free survival rates (p = 0.02 and p < 0.01, respectively), but only apoptotic extent provided independent prognostic information by multivariate analysis. CONCLUSIONS: The evaluation of bcl-2 expression and extent of apoptosis may provide useful prognostic information on breast cancer patients; however while increased apoptosis is strongly associated with the progression from primary carcinomas to lymph node metastases, bcl-2 does not seem to play a significant role in this process.

Investigation of single strand conformational alterations of the TP53 gene in epithelial hyperplasias of the breast

Generally, benign breast lesions behave as innocuous and limited proliferations, but sometimes they can represent pre-cancerous diseases. The practical importance of epithelial hyperplasias studies is related to their potential for malignant transformation. The TP53 tumor supressor gene suffers the greatest number of mutations in human cancer Using single strand conformational polymorphism, we did a mutation screening in exons 5 to 8 of the TP53 gene in the tumoral tissues of five patients with epithelial hyperplasias of the breast. The obtained results do not show any polymorphism that indicates mutation. The lack of mutation indicates that this gene is not involved in the initial process of malignization, strengthening the hypothesis that mutations on TP53 gene are a late event in the breast carcinogenesis.

Cytogenetics of epithelial hyperplasias of the human breast.

Generally, benign breast lesions behave like innocuous and limited proliferations; however, sometimes they can represent precancerous pathologies. The cytogenetic analysis of five mammary epithelial hyperplasias is reported. Four cases had clonal chromosome alterations. All of the cases presented a modal number of 46 chromosomes. Chromosome 9 monosomies and chromosome 1 deletions were common in these benign tumors. The study of benign proliferations of the breast may reveal a possible relationship between chromosomal alterations and the conditions of the tissue.

Karyotypic and histopathologic findings in an accessory breast.

Accessory breasts are a clearly hereditary anomaly. They enlarge during pregnancy and lactation as a consequence of high blood levels of estrogen and prolactin, and are subject to all the diseases that occur in normal breasts. Cytogenetic analysis was performed on one accessory breast. The monossomy of chromosome 16 was the main alteration found in this material. Nonscheduled cell proliferations may produce chromosome alterations, most of them with no clinical meaning. When relevant genes are altered, major proliferations or progression to malignancy may occur.

Karyotypic and histopathologic findings in an accessory breast

Accessory breasts are a clearly hereditary anomaly. They enlarge during pregnancy and lactation as a consequence of high blood levels of estrogen and prolactin, and are subject to all the diseases that occur in normal breasts. Cytogenetic analysis was performed on one accessory breast. The monossomy of chromosome 16 was the main alteration found in this materal. Nonscheduled cell proliferations may produce chromosome alterations, most of them with no clinical meaning. When relevant genes are altered, major proliferations or progression to malignancy may occur.

Risk factors for breast cancer mortality among the National Breast Screening Study of Canada participants.

We studied the relationship between risk factor information and breast cancer mortality by means of a case control study, nested within the population of the National Breast Screening Study of Canada (NBSS). The characteristics of women aged 40-59 years, identified at the initial screen, who subsequently died of breast cancer up to 7 years from the initial screen, were compared with those of controls drawn from the same population. Among the factors evaluated in this study, number of live births and presence of symptoms in the breast revealed on direct questioning were found to be significantly related to breast cancer mortality. The results suggest a decrease in risk of dying of breast cancer associated with one or more live births (OR: 0.79, 95% CI: 0.68, 0.93), and an increase in risk of dying of breast cancer associated with symptoms in the breast revealed on direct questioning at the initial screen (OR: 2.01, 95% CI: 1.20, 3.37).