Typical medullary breast carcinomas have a basal/myoepithelial phenotype

Medullary breast cancer (MBC) is a rare, diagnostically difficult, pathological subtype. Despite being high grade, it has a good prognosis. MBC patients have an excess of BRCA1 germ-fine mutation and reliable identification of MBC could help to identify patients at risk of carrying germline BRCA1 mutations or in whom chemotherapy could be avoided. The aim of this study was therefore to improve diagnosis by establishing an MBC protein expression profile using immunohistochemistry (IHC) on tissue-microarrays (TMA). Using a series of 779 breast carcinomas ('EC' set), diagnosed initially as MBC, a double-reading session was carried out by several pathologists on all of the histological material to establish the diagnosis as firmly as possible using a 'medullary score'. Only MBCs with high scores, i.e. typical MBC (TMBC) (n = 44) and non-TMBC grade III with no or low scores (n = 160), were included in the IHC study. To validate the results obtained on this first set, a control series of TMBC (n = 17) and non-MBC grade III cases (n = 140) ('IPC' set) was studied. The expression of 18 proteins was studied in the 61 TMBCs and 300 grade III cases from the two sets. The global intra-observer concordance of the first reading for the diagnosis of TMBC was 94%, with almost perfect kappa (kappa) of 0.815. TMBC was characterized by a high degree of basal/myoepithelial differentiation. In multivariate analysis with logistic regression, TMBC was defined by the association of P-cadherin (R = 2.29), MIB1 > 50 (R = 3.80), ERBB2 negativity (R = 2.24) and p53 positivity (RR = 1.45). Copyright (c) 2005 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.

Thermal biofeedback, locus of control and precompetitive anxiety in young athletes

Small groups of athletes (maximum size 8) were taught to voluntarily control their finger temperature, in a test of the feasibility of thermal biofeedback as a tool for coaches. The objective was to decrease precompetitive anxiety among the 140 young, competitive athletes (track and field, N=61; swimming, N=79), 66 females and 74 males, mean age 14.8 years, age range 8.9-20.5 years, from local high schools and swimming clubs. The biofeedback (visual and auditory) was provided by small, battery-powered devices that were connected to thermistors attached to the middle finger of the dominant hand. An easily readable digital LCD display, in 0.01 degrees C increments, provided visual feedback, while a musical tone, which descended in pitch with increased finger temperature, provided the audio component via small headphones. Eight twenty minute sessions were scheduled, with 48 hours between sessions. The measures employed in this prestest-posttest study were Levenson's locus of control scale (IPC), and the Competitive Sport Anxiety Inventory (CSAI-2). The results indicated that, while significant control of finger temperature was achieved, F(1, 160)=5.30, p