Widespread acceptance of breast conserving surgery for early breast cancer has led to renewed interest in multifocality, which is seen in 13-63% of breast cancers. According to current guidelines, oestrogen/progesterone receptor status is assessed on the sample obtained at initial core biopsy or the main tumour focus in multifocal breast cancer (more than one distinct tumour focus in a quadrant). We assessed receptor status of individual foci in multifocal breast cancer. Mastectomy specimens for 18 cases of multifocal breast cancer were identified. Immunohistochemical staining for oestrogen and progesterone receptors was performed on all tumour foci. On histological examination 11 patients demonstrated two independent tumour foci, three demonstrated three foci and four demonstrated four foci. Minor differences in oestrogen receptor score were seen between foci (attributed to the subjective nature of the scoring system), which did not affect the overall positive/negative classification. Sixteen patients (88%) were oestrogen receptor-positive. Progesterone receptor staining showed more variability between foci in two patients but, since the tumours were oestrogen receptor-positive this would not have affected clinical decision-making. No major differences in oestrogen receptor status between multiple tumour foci in the same quadrant were found in this pilot study.

Background: Neoadjuvant therapy results in a significant increase in breast-conserving surgery. However, traditional imaging methods are unable to accurately predict the extent of viable residual disease leading to uncertainty in surgical planning and some previous studies have shown a disproportionately high incidence of locoregional recurrence. Dynamic contrast enhanced-MRI (DCE-MRI) has been shown to provide a potentially more accurate prediction of residual disease.Results: Patients undergoing neoadjuvant chemotherapy for breast cancer in our unit are staged with the DCE-MRI of the breast performed at 1.5 T before, during and after treatment and the final result was used to plan surgery. Two hundred and four patients with breast cancer were treated with neoadjuvant chemotherapy between 1996 and April 2005. Eighteen of these patients had distant metastases at the time of initial diagnosis and so were excluded from the present study. Following neoadjuvant chemotherapy, 186 patients underwent surgical treatment. Of these, 68 patients had breast-conserving surgery. At a median follow up of 30 months (range: 5.6-72 months) 21 patients in this group developed subsequent recurrence (21/68 - 30%) of whom 9 (9/68 - 13%) had locoregional recurrence, 7 had local recurrence (7/68 - 10%), and 17 (17/68 - 25%) had distant recurrence. Logistic regression analysis repealed only vascular invasion (p = 0.006) of the tumour to be significantly associated with overall recurrence. None of the pathological factors (ER, PR status, vascular invasion, lymph node metastases, pathological complete response to neoadjuvant chemotherapy) showed a significant association with locoregional recurrence.Conclusion: Breast-conserving surgery with DCE-MRI planning after neoadjuvant chemotherapy provides an acceptable level of local recurrence without the need for mastectomy. (c) 2006 Elsevier Ltd. All rights reserved.

Dissolved oxygen levels in bottom waters of Hood Canal have been recorded both recently and historically at low levels that adversely affect the condition of resident pelagic and demersal biota. It is well documented that low dissolved oxygen levels can adversely affect infaunal invertebrate populations as well. Although the condition of the Hood Canal benthos has been assessed periodically for over a decade, synaptic dissolved oxygen measurements from bottom waters are lacking. In June 2004, as part of the Puget Sound Ambient Monitoring Program, the Washington State Department of Ecology’s Marine Sediment Monitoring Team sampled sediments from 30 stations in Hood Canal to measure physical characteristics, the extent of chemical contamination and toxicity, and infaunal community structure. Dissolved oxygen measures were simultaneously collected in near bottom waters at each station. Results indicated that sediment contamination and toxicity were low throughout the canal, while measures of total abundance, species richness, and dissolved oxygen decreased in the central and southern stations. These data are being analyzed, along with sets of historical sediment and water column data, to elucidate relationships that may exist between varying dissolved oxygen levels and benthic community structure, in an environment relatively free of severe chemical and toxicological impact.

Sediment quality in Puget Sound is monitored by the Department of Ecology annually as a component of the Puget Sound Ambient Monitoring Program (PSAMP). The primary objectives of this program are to quantify the spatial extent and geographic patterns of degraded sediment quality. Using the Sediment Quality Triad approach, data are evaluated on the chemical contamination and toxicity of sediments along with analyses of the composition of the resident infaunal benthos. During June of 2002 and 2003, Ecology collected 81 samples in the bays and inlets of the San Juan Islands, eastern Strait of Juan de Fuca, and Admiralty Inlet. A stratified-random method was used to identify sampling locations. Analyses included quantitation of 118 potentially toxic chemicals, a battery of four laboratory toxicity tests, and the evaluation of infaunal community structure. Results of these analyses were compiled from the two survey periods and merged to identify spatial patterns and spatial extent of degraded sediment quality in these three regions. The triad analysis suggests that the sediment quality in these three regions was comparable to that of some of the least degraded regions previously studied by this program.