Figure 1.

Representative MYC immunohistochemical staining and corresponding two-color fluorescence in situ hybridization (MYC in red and centromere 8 in green) in matched primary and metastatic breast cancers from rapid autopsies (A–H) and surgical specimens (I–P). The primary in case 9 was MYC positive by immunolabeling and scored as a moderate expressor (A), while the corresponding metastasis was MYC negative (B). This result was inconsistent with fluorescence in situ hybridization, where the metastasis acquired MYC amplification (D), but no abnormalities in MYC copy number were detected in the primary (C). In contrast, the primary in case 11 was MYC negative (E), while the metastasis was MYC positive (F, moderate expressor). By fluorescence in situ hybridization, MYC was duplicated in the primary (G) and amplified in the metastasis (H). In case 25, both the primary (I) and metastasis (J) were MYC positive. However, only half the number of cells stained for MYC in the metastasis as compared to the primary. By fluorescence in situ hybridization, MYC copy number relative to centromere 8 remained unchanged (K, primary and L, metastasis). For case 20, an increase in MYC immunostaining was observed in the metastasis (N, moderate expressor) as compared to the primary (M, low expressor). Further, while MYC was neither duplicated or amplified in the primary (O), MYC was amplified in the metastasis (P). See Tables 2 and 3 for c-myc immunohistochemistry and fluorescence in situ hybridization MYC to centromere 8 ratios for each primary and corresponding metastases.