MRI was the most accurate imaging technique in detecting a primary BPL in IBC patients. Sonography can be useful in diagnosing regional nodal disease. PET/CT provides additional information on distant metastasis, and it should be considered in the initial staging of IBC.

The concept of cancer cells being hierarchically organized and arising from their own progenitor stem cells will have important implications on cancer therapy. If this hypothesis were to be true then the paucity of estrogen receptors in stem cells as well as their inherent drug resistance mechanisms pose a challenge to current targeted therapies. In this study, we sought to examine the prognostic relevance of ALDH1, a putative cancer stem cell marker, by immunohistochemistry. The four cohorts analyzed included an adjuvantly treated series of 245 invasive cancers, a neoadjuvantly treated series of 34 cases, and two series of 58 and 40 triple negative cases, respectively. Both tumor cell and stromal expression for ALDH1 was evaluated, where possible. Tumor cell ALDH1 expression significantly correlated only with basal-like and HER2 tumor types in the adjuvant series and tumor grade in the neoadjuvant cohort. No significant enrichment for ALDH1 positive cells was observed in the postneoadjuvant therapy specimens compared to pretreatment samples. On the other hand, high degree of stromal expression was significantly associated with best disease-free survival as well as a trend for overall survival. The association of stromal expression was confirmed in an independent cohort of triple negative cases. The novel finding is that tumor microenvironment may play a significant role in determining the prognostic impact of stem/progenitor cells in human breast tumors.

BACKGROUND.The prognosis for patients with esophageal and esophagogastric junction (EGJ) adenocarcinoma remains poor, even after surgical resection. Pathologic assessment of depth of invasion and lymph node status are the primary prognostic factors in these patients. In patients with esophageal squamous cell carcinoma, increased epidermal growth factor receptor (EGFR) expression has been associated with a worse prognosis. It is not known whether EGFR plays a similar role in esophageal and EGJ adenocarcinomas.METHODS.To address this issue, the authors studied tumor specimens from 103 patients with surgically resected esophageal and EGJ adenocarcinomas (9 patients with stage I disease, 23 patients with stage II disease, 57 patients with stage III disease, and 14 patients with stage IV disease). The expression of EGFR was assessed by immunohistochemical analysis of tissue microarrays. Tumors were considered positive for EGFR expression when >5% of tumor cells were stained and negative when ≤5% of tumor cells were stained.RESULTS.EGFR was expressed in 33 of 103 adenocarcinomas (32%) and was correlated with higher pathologic tumor (T) classification (P = .02), the presence of lymph node metastasis (P = .01), and higher pathologic tumor, lymph node, metastasis classification (P = .02). EGFR expression also was correlated with shorter disease‐free and overall survival in univariate analyses (P = .001 and P = .004, respectively), and there was a trend toward a correlation between EGFR expression and shorter disease‐free survival in multivariate analyses (P = .07 and P = .08). The results demonstrated that EGFR expression in esophageal adenocarcinomas was correlated with advanced pathologic tumor classification and lymph node metastasis. EGFR expression also was correlated with poor disease‐free and overall survival, but that correlation was not independent of T classification.CONCLUSIONS.The current findings suggested that EGFR expression correlates with poor prognostic factors and may be used to predict patient outcomes. Cancer 2007. © 2007 American Cancer Society.

Pseudoangiomatous stromal hyperplasia tumors are rare. In this retrospective study, we evaluated the clinical, radiologic, and pathologic features of pseudoangiomatous stromal hyperplasia tumors and compared histologic findings of pseudoangiomatous stromal hyperplasia tumors with clinical outcome. We identified 26 patients (mean age, 47 years) with pseudoangiomatous stromal hyperplasia tumors who had been diagnosed at our institution. Sixteen patients (62%) were premenopausal, and 13 (50%) had a history of oral contraceptive or hormone replacement therapy use. Ten patients (38%) presented with a palpable mass; in the other patients, the tumors were detected by mammography (where it usually appeared as a hyperdense mass with irregular margins) or sonography (where it usually appeared as a hypoechoic mass). Lesions were a mean of 4.2 cm at the largest dimension (range, 0.8-11 cm). Histologically, pseudoangiomatous stromal hyperplasia was classified as simple in 18 patients (69%) and fascicular/proliferative in eight patients (31%). In one patient (4%), an invasive ductal carcinoma was present within the pseudoangiomatous stromal hyperplasia tumor. We found associated benign epithelial lesions in eight patients (31%) and/or gynecomastia-like changes in 17 patients (65%). The presence of gynecomastia-like changes was significantly associated with intralobular location of pseudoangiomatous stromal hyperplasia (P ¼ 0.00085, by Fisher's exact test). Follow-up data were available for 15 patients (mean±s.d., r27±17 months). No additional pathology or substantial changes in existing lesions were found on imaging. All pseudoangiomatous stromal hyperplasia tumors diagnosed by core needle biopsy but not subsequently excised remained clinically and radiologically stable; therefore, offering the option of close clinical surveillance instead of surgery in patients with pseudoangiomatous stromal hyperplasia tumors diagnosed by core needle biopsy in selected patients.

Objectives: Aboriginal Canadians have a high burden of obesity and obesity‐related chronic conditions. Body mass index (BMI) trajectories from 1994 to 2009 were estimated for Aboriginal and non‐Aboriginal Canadians using self‐reported height and weight data from the National Population Health Survey to explore age, period, and cohort effects of BMI change. Methods: Linear growth curve models were estimated for 311 Aboriginal and 10,967 non‐Aboriginal respondents divided into five birth cohorts born in the 1940s, 50s, 60s, 70s, and 80s. Results: Overall, Aboriginal Canadians experienced higher rates of BMI increase over the 14‐year period. Rate of BMI increase was specifically higher for Aboriginal adults born in the 1960s and 1970s when compared with non‐Aboriginal adults. At ages 25, 35, and 45, recent‐born cohorts had consistently higher BMIs compared with earlier‐born cohorts with magnitudes of differences typically larger in the Aboriginal population. Recent‐born cohorts also exhibited steeper BMI trajectories. Conclusions: Cohort effects may be responsible for the divergent BMI trajectories between Aboriginal and non‐Aboriginal Canadians born in the 1960s and 1970s. Aboriginal Canadians, particularly of more recent‐born cohorts, experienced faster increases in BMI from 1994 to 2009 than non‐Aboriginal Canadians, suggesting that prevalence of obesity will continue to rise in this population without intervention. Am. J. Hum. Biol., 2012. © 2012 Wiley Periodicals, Inc.