Prognostic and Predictive Biomarkers in Familial Breast Cancer.

Large numbers of breast cancers arise within a familial context, either with known inherited germline mutations largely within DNA repair genes, or with a strong family history of breast and/or ovarian cancer, with unknown genetic underlying mechanisms. These cancers appear to be different to sporadic cases, with earlier age of onset, increased multifocality and with association with specific breast cancer histological and phenotypic subtypes. Furthermore, tumours showing homologous recombination deficiency, due to loss of BRCA1, BRCA2, PALB2 and CHEK2 function, have been shown to be especially sensitive to platinum-based chemotherapeutics and PARP inhibition. While there is extensive research and data accrued on risk stratification and genetic predisposition, there are few data pertaining to relevant prognostic and predictive biomarkers within this breast cancer subgroup. The following is a review of such biomarkers in male and female familial breast cancer, although the data for the former are particularly sparse.

Gynaecomastia-like change of a female breast with tri-layer ductal epithelium as described in the male breast.

A 31-year-old female presented with asymmetrical fullness in the right breast and was found to have a large span of fibrocystic change and nodular glandular tissue on magnetic resonance imaging. Breast malignancy could not be excluded, and thus excisional biopsy was performed. Histopathology revealed a rare finding of gynaecomastia-like histopathological changes of a female breast. Gynaecomastia is traditionally a clinical condition affecting the male breast and characterized by ductal hyperplasia, periductal fibrosis and oedema of the tissue. We describe the first finding of gynaecomastia-like change with a tri-layer ductal epithelium in a female breast, as previously described in the male breast.

Smoking in film in New Zealand: measuring risk exposure.

BACKGROUND: Smoking in film is a risk factor for smoking uptake in adolescence. This study aimed to quantify exposure to smoking in film received by New Zealand audiences, and evaluate potential interventions to reduce the quantity and impact of this exposure. METHODS: The ten highest-grossing films in New Zealand for 2003 were each analysed independently by two viewers for smoking, smoking references and related imagery. Potential interventions were explored by reviewing relevant New Zealand legislation, and scientific literature. RESULTS: Seven of the ten films contained at least one tobacco reference, similar to larger film samples. The majority of the 38 tobacco references involved characters smoking, most of whom were male. Smoking was associated with positive character traits, notably rebellion (which may appeal to adolescents). There appeared to be a low threshold for including smoking in film. Legislative or censorship approaches to smoking in film are currently unlikely to succeed. Anti-smoking advertising before films has promise, but experimental research is required to demonstrate cost effectiveness. CONCLUSION: Smoking in film warrants concern from public health advocates. In New Zealand, pre-film anti-smoking advertising appears to be the most promising immediate policy response.