Studies of cell models and profiling of clinical breast cancer material to reveal the mechanisms of resistance to anti-oestrogen therapy, and to tamoxifen in particular, have reported that this phenomenon can be associated with increased expression and signalling through erbB Type 1 growth factor receptors, notably the epidermal growth factor receptor (EGFR) and HER2. Further molecular studies have revealed an intricate interlinking between such growth factor receptor pathways and oestrogen receptor (ER) signalling. Inhibition of receptor tyrosine kinase activity involved in the EGFR signalling cascade forms the basis for the use of EGFR specific tyrosine kinase inhibitors exemplified by gefitinib (ZD1839, Iressa) and erlotinib (OSI-774, Tarceva). Such agents have proved promising in pre-clinical studies and are currently in clinical trials in breast cancer, where gefitinib has been studied more extensively to date. Here, we present an overview of the current development of gefitinib in clinical breast cancer. This includes results from our clinical breast cancer trial 1839IL/0057 that demonstrate the efficacy of gefitinib within ER-positive, tamoxifen-resistant patients with locally advanced/metastatic disease, where parallel decreases in EGFR signal transduction and the Ki67 (MIB1) proliferation marker can be detected as predicted from model system studies. We also consider trials examining combination treatment with gefitinib and anti-hormonal strategies that will begin to address the clinically important question of whether gefitinib can delay/prevent onset of anti-hormone resistance.Endocrine-Related Cancer (2005) 12 S135-S144

We report 13 boys in whom the testis ascended from the normal scrotal position to an undescended position. A patent processus vaginalis was identified in 10 patients at orchidopexy and is believed to have contributed to testicular ascent. The other three patients had retractile testes which were held in the high position by surrounding adhesions.

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Background: Patients who are elderly or who have locally advanced breast cancer may initially receive primary medical therapy.Methods: In order to avoid open biopsy in such patients, we routinely perform both fine needle aspiration cytology (FNAC) and core‐biopsy at the first clinic visit.Results: A retrospective review showed that of 109 such patients, 87 (80%) had the diagnosis confirmed on FNAC and 96 (88%) on core‐biopsy. Only eight patients did not have a diagnostic result from the first clinic visit, and five of these patients were diagnosed on a repeat core‐biopsy or FNAC. The remaining three patients had suspicious FNAC. Overall 97% had one or both investigations positive.Conclusions: When considered alone core‐biopsy was superior to FNAC. In this series the combined diagnostic approach of FNAC and core‐biopsy has allowed outpatient diagnosis for virtually all patients.