PPM1D (protein phosphatase magnesium-dependent 1d) maps to the 17q23.2 amplicon and is amplified in B8% of breast cancers. The PPM1D gene encodes a serine threonine phosphatase, which is involved in the regulation of several tumour suppressor pathways, including the p53 pathway. Along with others, we have recently shown that PPM1D is one of the drivers of the 17q23.2 amplicon and a promising therapeutic target. Here we investigate whether PPM1D is overexpressed when amplified in breast cancers and the correlations between PPM1D overexpression and amplification with clinicopathological features and survival of breast cancer patients from a cohort of 245 patients with invasive breast cancer treated with therapeutic surgery followed by adjuvant anthracycline-based chemotherapy. mRNA was extracted from representative sections of tumours containing 450% of tumour cells and subjected to TaqMan quantitative real-time PCR using primers for PPM1D and for two housekeeping genes. PPM1D overexpression was defined as the top quartile of expression levels. Chromogenic in situ hybridization with in-house-generated probes for PPM1D was performed. Amplification was defined as 450% of cancer cells with 45 signals per nucleus/large gene clusters. PPM1D overexpression and amplification were found in 25 and 6% of breast cancers, respectively. All cases harbouring PPM1D amplification displayed PPM1D overexpression. PPM1D overexpression was inversely correlated with expression of TOP2A, EGFR and cytokeratins 5/6 and 17. PPM1D amplification was significantly associated with HER2 overexpression, and HER2, TOP2A and CCND1 amplification. No association between PPM1D gene amplification and PPM1D mRNA overexpression with survival was observed. In conclusion, PPM1D is consistently overexpressed when amplified; however, PPM1D overexpression is more pervasive than gene amplification. PPM1D overexpression and amplification are associated with tumours displaying luminal or HER2 phenotypes. Co-amplification of PPM1D and HER2/TOP2A and CCND1 are not random events and may suggest the presence of a 'firestorm' genetic profile. Keywords: breast cancer; chromogenic in situ hybridization; p53; prognosis; real time reverse transcriptase PCR; therapeutic target PPM1D (protein phosphatase magnesium-dependent 1d), also known as WIP1 (wild-type p53-induced phosphatase 1), is a member of the nuclear type 2C protein phosphatase family.1 The PPM1D gene maps to 17q23.2, a genomic region recurrently amplified in several types of tumours including medulloblastomas, neuroblastomas, pancreatic adenocarcinomas, ovarian clear cell carcinomas and breast cancers. [2][3][4][5][6][7][8][9][10] We have recently shown in a series of 95 grade III invasive breast cancers that PPM1D is amplified in 7% of luminal and 20% of HER2 amplified cancers and that PPM1D is consistently overexpressed at the mRNA level in cases harbouring PPM1D gene amplification.9