2007 Winter Meeting - London - The Pathological Society of Great ...

PL1PL2Triple negative (ER, PR and HER2 negative) breast cancer:an appraisal of morphology and its prognostic markers{P} E Rakha, A Green, I EllisNottingham University, Nottingham, United KingdomBackground: Triple negative (TN) breast cancer (estrogen receptor (ER),progesterone receptor (PR) and HER2 negative) is a high risk group of breastcancer that lacks the benefit of specific therapy which targets these proteins.The aim of this study is to characterize this group and to identify prognosticmarkers which can identify tumours with the more aggressive behaviour.Methods: we have examined a large and well characterized series of invasivebreast carcinoma (n=1944) with a long term clinical follow-up (median 56months) using tissue microarray. The series were also stained with concurrentimmunohistochemical prognostic biomarkers. Results: TN phenotypeconstituted 16.3% of the informative cases. There were positive associationswith larger size, higher grade, pushing margins, poorer Nottingham PrognosticIndex, development of recurrence and distant metastasis and shorter survival.In addition, associations were found with loss of expression of androgen (AR),and E-cadherin and positive expression of basal CKs (BP), P-cadherin, p53 andEGFR. In all TN series, tumour size, lymph node (LN) stage and AR were themost useful prognostic markers. In the LN positive subgroup, both size and ARretained their prognostic significance. However, in the LN-negative tumours,BP was the sole prognostic marker identified in this subgroup. Conclusion: TNphenotype is a specific subgroup of breast cancer associated with aggressivebehaviour and poor outcome. Assessment of AR and BP, in addition to theestablished pathologic variables mainly LN and size, can be used to select highandlow-risk patients at the time of primary surgery and can provide valuableinformation on treatment options in these TN tumoursThis abstract is not availablefor publicationuntil after presentationat the MeetingPL3Post-Mortem Investigation of Sudden Unexpected Death inInfancy: 10-year Experience from a Single Specialist Centre{P} MA Weber, I Brooke, K Wingrove, RA Risdon, M Malone,NJ SebireUCL Institute of Child Health and Great Ormond Street Hospital forChildren, London, United KingdomIntroduction: Sudden unexpected death in infancy (SUDI) constitutes the mostcommon cause of non-neonatal death in the first year of life. Several autopsyprotocols have been suggested, all of which include a range of ancillaryinvestigations.Methods: Retrospective analysis of >1,500 consecutively performed postmortemexaminations, all of which were carried out by specialist paediatricpathologists at a single centre. SUDI was defined as death of an infant aged 7 to365 days that was sudden and unexpected. A local autopsy protocol wasfollowed that included the use of detailed ancillary investigations. To ensureconsistency for data analysis and interpretation, all data extraction, data entryand classification was carried out by a single paediatric pathologist according toclearly defined criteria.Results: Of 1,516 post-mortem examinations overall, 546 cases presented asSUDI. In a third of infants (180 cases) death was explained by the autopsyfindings (“explained SUDI”). The other 366 cases (67%) remainedunexplained. Of these, more than 40% were co-sleeping associated deaths.Most deaths occurred in the first 3 months of age, and there was no significantseasonal variation. Of the explained deaths, just over half were infective, mostcommonly due to pneumonia, whilst the commonest non-infective causes ofdeath included congenital abnormalities, and accidental and non-accidentaldeaths.Discussion: This constitutes the largest single institution autopsy study ofSUDI. Ten years on from the CESDI study, the ascertainment of a cause ofdeath at autopsy has not changed, with two thirds of SUDI deaths remainingunexplained even after detailed post-mortem examination by a specialistpaediatric pathologist in accordance with current guidelines.PL4Quality of surgical resection and short course radiotherapyreduce local recurrence and improve disease free survival inrectal cancer. Preliminary results from the MRC CR07 trial.{P} P Quirke, D Sebag-Montefiore, L Thompson, B Steele,B Grieve, S Khanna, J Monson, Richard Stephens, MRC CR07Trial InvestigatorsMRC Clinical Trials Unit, London, United KingdomMRC CR07 randomised to surgery alone with chemoradiotherapy for patientswith an involved circumferential margin (CRM) or 5x5 radiotherapy. Results at3 years are local recurrence (LR) dropped from 11% to 5% (p