Amplification of c-myc gene and overexpression of c-Myc protein in breast cancer and adjacent non-neoplastic tissue
Introduction
Breast cancer is one of the most common tumors in women, and the number of new cases increases continuously worldwide. The clinical course of this disease is highly variable. This includes cases with rapid progression and a short time of survival, but also patients with completely disease free interval of more than 10 yr. The reason for such variability is not fully understood and clinicians continuously search for prognostic parameters that can accurately predict prognosis, and indicate a suitable adjuvant therapy for each patient.
Accumulation of various genetic damage is a hallmark of human cancers. Many of these genetic alterations now have been identified. Over the past several years a vast number of experimental data on involvement of c-myc gene alterations in human breast cancer accumulated. c-Myc protein is a product of c-myc proto-oncogene and exerts diverse effects on cell behavior. Data gathered to date indicate that c-Myc protein plays a critical role in normal cell-cycle progression, inhibition of terminal differentiation and induction of programmed cell death [1], [2], [3]. On the other hand, deregulated c-Myc expression as a consequence of genetic changes has been observed in a variety of neoplasms [4]. Several reports indicate that genetic alterations of c-myc oncogene play an important role in induction and progression of human breast cancer [5], [6], [7], [8], [9]. Occurrence of c-myc oncogene amplification in breast cancer has been related to poor prognosis [10], [11], [12]. Overexpression of c-Myc protein to some extend correlates with gene amplification but not all tumors with c-myc amplification displayed increased level of this oncoprotein and some tumors displayed c-Myc overexpression without gene amplification [13], [14]. Despite over 15 yr continuous clinical work, the prognostic utility of c-myc gene alterations in breast cancer is still uncertain.
The level of c-myc expression in breast cancer was mostly investigated by measuring the level of mRNA [15], [16], [17]. Such a measurement does not necessary correlate with the protein level. The previous immunohistochemical examination of 206 breast cancers indicated that long recurrence-free survival of the patients was related to overexpression of c-Myc protein [18]. In search for ways to improve the characterization of breast cancer it would be important to examine the relationship between c-myc amplification and overexpression of c-Myc protein and widely used clinical and pathologic prognostic factors. In this report, we investigate amplification of c-myc and c-Myc protein level in primary breast cancer and adjacent nonneoplastic specimens. To gain insight into value of these parameters we analyzed the relation of overexpression and amplification of c-myc to several prognostic factors such as tumor size, estrogen and progesterone receptor status, mitotic index, local metastases and histologic grading.
Section snippets
Materials and methods
The studies were conducted on 94 ductal and lobular cancers selected from a pool consecutively accessioned cases. Patients with primary breast cancer had either an excision biopsy or a modified radical mastectomy. All specimens were measured and serially sectioned. All tissues were reviewed by a single pathologist (A. K.). Infiltrating cancers were considered ductal or lobular based upon their predominant cell type. Each specimen was dissected in a 5 mm bread-loaf fashion and tumor was measured
Results
The status of c-myc gene was studied on DNA isolated from 94 human breast cancers (lobular carcinoma and ductal carcinoma) and corresponding adjacent nonneoplastic tissues. To ruled out aneuploidy frequently occurring in developing tumors we used the gene for tissue plasminogen activator (TPA) located on chromosome 8 as a reference gene. Amplification of c-myc gene was considered to occur when the products of multiplex PCR displayed the intensity ratio (c-myc: TPA) equal or higher to that
Discussion
Data published to date indicate that oncogene amplification is one of the most common genetic alteration found in human cancers [22]. Amplification of c-myc has been demonstrated in 10 to 40% of breast cancers [6], [7], [8], [11], [12], [13]. The presence of c-myc amplification has also been shown to be a strong indicator of poor prognosis [7], [12]. We have studied amplification of c-myc gene in human breast cancers and adjacent nonneoplastic tissues by means of the semiquantitative multiplex
Acknowledgements
The authors wish to thank dr. R. Kowara for helpful discussion and dr. G. Kobierska for assistance in pathomorphological examination.
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