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Selective regain of egfr gene copies in CD44+/CD24-/lowbreast cancer cellular model MDA-MB-468
© Agelopoulos et al; licensee BioMed Central Ltd. 2010
Received: 4 September 2009
Accepted: 3 March 2010
Published: 3 March 2010
Increased transcription of oncogenes like the epidermal growth factor receptor (EGFR) is frequently caused by amplification of the whole gene or at least of regulatory sequences. Aim of this study was to pinpoint mechanistic parameters occurring during egfr copy number gains leading to a stable EGFR overexpression and high sensitivity to extracellular signalling. A deeper understanding of those marker events might improve early diagnosis of cancer in suspect lesions, early detection of cancer progression and the prediction of egfr targeted therapies.
The basal-like/stemness type breast cancer cell line subpopulation MDA-MB-468 CD44high/CD24-/low, carrying high egfr amplifications, was chosen as a model system in this study. Subclones of the heterogeneous cell line expressing low and high EGF receptor densities were isolated by cell sorting. Genomic profiling was carried out for these by means of SNP array profiling, qPCR and FISH. Cell cycle analysis was performed using the BrdU quenching technique.
Low and high EGFR expressing MDA-MB-468 CD44+/CD24-/low subpopulations separated by cell sorting showed intermediate and high copy numbers of egfr, respectively. However, during cell culture an increase solely for egfr gene copy numbers in the intermediate subpopulation occurred. This shift was based on the formation of new cells which regained egfr gene copies. By two parametric cell cycle analysis clonal effects mediated through growth advantage of cells bearing higher egfr gene copy numbers could most likely be excluded for being the driving force. Subsequently, the detection of a fragile site distal to the egfr gene, sustaining uncapped telomere-less chromosomal ends, the ladder-like structure of the intrachromosomal egfr amplification and a broader range of egfr copy numbers support the assumption that dynamic chromosomal rearrangements, like breakage-fusion-bridge-cycles other than proliferation drive the gain of egfr copies.
Progressive genome modulation in the CD44+/CD24-/low subpopulation of the breast cancer cell line MDA-MB-468 leads to different coexisting subclones. In isolated low-copy cells asymmetric chromosomal segregation leads to new cells with regained solely egfr gene copies. Furthermore, egfr regain resulted in enhanced signal transduction of the MAP-kinase and PI3-kinase pathway. We show here for the first time a dynamic copy number regain in basal-like/stemness cell type breast cancer subpopulations which might explain genetic heterogeneity. Moreover, this process might also be involved in adaptive growth factor receptor intracellular signaling which support survival and migration during cancer development and progression.
Increased transcription of (proto-) oncogenes is frequently caused by amplification. This has already been shown for numerous genes for example in lung , pancreatic , brain  and breast cancer . It is still under debate if this process is the dominant cancer cause and promoter of cancer progression or if distinct DNA sequence mutations have to lead the way. Clonal selection during cancer development may lead to a dominant cancer cell subpopulation with distinct chromosomal alterations. But, in most cases a heterogeneous cell population can be found within one tumour. Here, the non-ambiguous relationship between the genotype of distinct loci and the phenotype is physiological a rare event and therefore, highly selective in cancer. Although, contemporary genetics has shown that quantitative trait loci exist , it is unlikely that the gene dosage sensitivity for a single locus significantly changes the phenotype of normal somatic cells. However, specific gene families e.g. involved in essential signal transduction systems show such dosage sensitivity in cancer. The most prominent example for those genes are the HER receptor family, most prominent EGFR, which induce signal transduction for survival, proliferation and migration. Patients suffering from carcinoma associated with gene amplification and overexpression of EGFR tend to have more aggressive diseases. EGFR overexpression has been associated with poor prognosis in human breast cancer [6, 7] and failure of endocrine therapy in breast cancer as well [8, 9].
Although, overexpression of EGFR may be regulated on the transcriptional level, in many cases aberrant activation of EGFR is mediated primarily by chromosomal changes generating increased egfr gene copy numbers. Amplifications of the egfr gene can be detected in vivo sometimes as double minutes but in most cases formation of homologous staining regions (HSR) as ladder like amplification structures can be observed. This was seen frequently in glioblastoma multiforme where amplification and overexpression of the egfr gene occurs in about 40% of the cases .
However, cell culture models reflecting these characteristics are fairly seldom. Even more, primary tumours taken into cell culture often loose their egfr gene amplification and by this the originally displayed heterogeneity [11, 12]. Among the remaining few cell culture models with conserved egfr amplifications and overexpression of the receptor the breast cancer cell line MDA-MB-468 as well as the subclone MDA-MB-468 CD44+/CD24-/LOW reflect best the above described findings. For both clones, not only a intrachromosomal high copy egfr gene amplification can be found which is based upon one abnormal chromosome 7 but also a heterogeneous cell population which differs in the grade of this amplification. Furthermore, the grade of amplification reflects the expression of the receptor. Far beyond these genetic properties MDA-MB-468 CD44+/CD24-/LOW is a valuable model for studies in breast cancer progression because it is likely to represent a basal-like/stemness cell phenotype of breast cancer. Besides the expression of cytokeratin 5/6 the subline investigated here consisted of CD44+/CD24-/low cells which supports the hypothesis that it has the intrinsic capability for asymmetric cell division [13, 14]. We therefore choose this cell line model to study the underlying mechanism as well as the kinetics of isolated egfr gene copy number variation.
MDA-MB-468 CD44+/CD24 -/LOW were described elsewhere . In contrary to the standard culture conditions (αMEM, 10% FBS) cells were cultured in Dulbecco's Modified Eagle Medium (DMEM) supplemented with nonessential amino acids (GIBCO/BRL), 5% fetal calf serum and antibiotics in a humidified 5% CO2 incubator at 37°C.
For the cell surface antigen staining, single cell suspensions were prepared by detaching 1-3 × 106 cells with 0.5 mM EDTA in phosphate buffered saline (PBS) for 5 min and washed twice with PBS at room temperature. Blocking was performed with 1% BSA in PBS for 30 min followed by incubation for 1 h on ice with the FITC labeled primary mouse monoclonal antibody EGFR 528 (Santa Cruz Biotechnology) targeting an extracellular epitope of EGFR. Two additional washing steps were followed and cells were resuspended in PBS.
Fluorescence Activated Cell Sorting (FACS)
Cell fluorescence signals were determined immediately after staining using a FACSVantage SE flow cytometer (Becton Dickinson) equipped with an argon laser emission of 488 nm. FITC was identified by using a 530 band pass filter. The analysis was performed using CELLQUEST software (Becton Dickinson). A primary gate based on physical parameters (forward and side light scatter, FSC and SSC, respectively) was set to exclude debris and cell aggregates. The background level was estimated by omitting the primary antibody. For isolation of subpopulations two additional gates were set discriminating clearly a high- from a low-level EGFR-expressing population. Either isolated cells were directly used for FISH, quantitative real-time PCR and SNP arrays respectively, or after adherence and cell culture as described above.
Particle Analyzing System (PAS)
For flow cytometric analysis a PAS III flow cytometer (Partec, Muenster, Germany) equipped with a 488-nm argon ion laser was used. Data acquisition and evaluation were done with FlowMax software (Quantum Analysis, Münster, Germany).
High resolution SNP analysis
DNA was extracted from MDA 468 high and low copy number cells and each was typed twice using GenChip® Human Mapping 500 k arrays (Affymetrix®). The intensity values were calculated as means of the both corresponding arrays. The data set was normalized by the dChip software which uses the invariant set normalization and a hidden Markov model . The SNP intensity values were calculated by referencing the means of each pair of repeated measurement to the means of a second pair repeated measurements (pairs: EGFR low vs. EGFR high). Regions of elevated or reduced copy number were calculated by DNAcopy package 1.10.0 and GLAD to identify and visualize change-points .
Quantitative real-time PCR (5' nuclease assay)
Quantitative real-time PCR for the egfr gene was carried out as previously described . PCR reactions (40 cycles; 15 seconds denaturation at 95°C; 1 minute primer annealing and extension at 60°C) were performed for egfr as well as for SOD2 at least in triplicates. DNA concentrations were normalized to the single copy gene SOD2. Amplification of the egfr gene was measured in MDA-MB-468 CD44+/CD24 -/LOW populations directly after isolation according to their EGFR-expression by FACS as well as in populations cultured for up to 92 days after sorting.
Fluorescence in situhybridization (FISH) on metaphase and interphase nuclei
Dividing cells were blocked in metaphase by addition of colcimide for at least 4 h before harvest. Interphase nuclei preparation was performed directly from these cultures. Standard cytogenetic techniques were used for harvesting and slide preparation.
FISH was carried out as previously described . In brief, probes were denatured for 5 min at 70°C in 70% formamid-0.6×SSC. Hybridization to the metaphase as well as interphase spreads was carried out overnight at 37°C in a 50% formamid-1×SSC-10% dextran sulfate solution in the presence of Cot-1-DNA (Gibco) and HPL-DNA (Sigma). Post-hybridization washes were performed at 45°C in 50% formamide-2×SSC. The chromosomes/nuclei were counterstained with DAPI, and images were captured with an Olympus BX61 microscope connected with a digital camera system DP50 (Hamburg, Germany).
Cell cycle/Proliferation analysis
Progression of cell cycle phases was determined using the BrdU quenching technique according to the protocol of Böhmer and Ellwart . Briefly, prior the above described sorting procedure cells were incubated for 18 h in 10 ml culture medium in the presence of 24 μg BrdU and 100 μg desoxycytidin. After cell sorting the cellular DNA of the subpopulations was stained for 1 h with 1.2 μg Hoechst 33342 and 1.5 μg ethidium bromide per milliliter Tris/NaCl buffer containing 0.1% Nonidet P40 and 0.2% bovine serum albumine (BSA).
For flow cytometric analysis a PAS III flow cytometer (Partec, Muenster, Germany) equipped with a mercury arc lamp for UV excitation was used. Ethidium bromide excitation was measured at 620 nm and Hoechst 33342 fluorescence at 455 nm. Data acquisition and evaluation were done with FlowMax software (Quantum Analysis, Muenster, Germany).
SDS-PAGE and western blot analysis
Protein separation was done using 10% polyacrylamide separation gels. Samples were diluted in SDS-sample buffer, heat denatured at 95°C for 5 min and loaded onto the gel under the following running conditions: 84 V for 1 h and 130 V until the dye front reached the edge of the gel. The molecular size standard was the peqGOLD protein-marker V (Peqlab, Erlangen, Germany). For Western Blot analysis separated samples (20 μg of protein) were transferred to a PDVF membrane under semi-dry conditions. Alpha-Tubulin, Akt, phospho-Akt (Ser473), EGFR, Erk, phospho-Erk (Thr202/Tyr204), CD44, CD24 and cytokeratin 5 were detected using the following primary antibodies: rabbit anti-human alpha-tubulin polyclonal Ig (Cell Signaling, Danvers, MA, USA), rabbit anti-human Akt polyclonal Ig (Cell Signaling), rabbit anti-human phospho-Akt polyclonal Ig (Cell Signaling), rabbit anti-human EGFR polyclonal Ig (Santa Cruz Biotechnology, Santa Cruz, USA), rabbit anti-human p44/42 MAP-Kinase polyclonal Ig (Cell Signaling), rabbit anti-human phospho-p44/42 MAP-Kinase polyclonal Ig (Cell Signaling), rabbit anti-human CD44 monoclonal Ig (abcam, Cambridge, United Kingdom) and mouse anti-human CD24 monoclonal Ig (dianova, Hamburg, Germany). Bands were visualized using the enhanced chemiluminescence detection system and X-ray films (both GE Healthcare, Uppsala, Sweden) in accordance to the manufacturer's instructions. X-ray films were digitized (GS-700 imaging densitometer, Bio-Rad) and processed (Quantity one, Bio-Rad). For quantitative analysis of the Erk and phospho Erk signal intensities, the signals of Erk1 and Erk2 were combined. For each Western Blot the signal intensities were normalized to the MDA-MB-468 CD44+/CD24 -/LOW high cultured in DMEM supplemented with 5% FCS (lane 1). Each reaction was performed in biological triplicates.
One of the main downstream effectors of the epidermal growth factor receptor (EGFR) is ras GTPase, an integral molecule of the mitogen activated protein kinase (MAPK) pathway which ends in the phosphorylation of extracellular signal regulated kinase (ERK). Activated ERKs translocate to the nucleus, where they phosphorylate and regulate various transcription factors leading to changes in gene expression. In particular, ERK-mediated transcription can result in the upregulation of EGFR ligands, such as EGF and TGFa, thus creating an autocrine feedback loop that is critical for Ras-mediated transformation and Raf-mediated gene expression changes. Western blot analysis of the subclones harbouring high and low egfr copy numbers revealed an increased sensitivity of the high egfr gene copy number subclone in response to EGF in as far the phosphorylation of erk 1/2 is obviously higher (Fig. 5b lane 3; for quantitative evaluation of western blot analysis see, Additional file 1) than in the low copy number subclone (Fig. 5b lane 6). Similar findings could be shown for the activation of Akt, another important downstream effector of the EGFR pathway. Taken together, the high egfr copy number MDA-MB-468 CD44+/CD24-/LOW cells represent cancer cells with a higher potential for survival, esp. at metastatic sites with low growth factor concentrations as the host tissue. A phenotype that can also be shown for cell lines with an HER2 amplification and constitutive activation of HER2, e.g. SKBR3 (Fig. 5A_lane 7-9) which displays high motogenicity.
The cell line MDA-MB-468 contains a subclone with a stemness phenotype CD44high/CD24-/low expression (Shown in Fig. 1, insert) [13, 14]. Using standard culture conditions this stable subclone does not show any phenotypically differences to the known MDA-MB-468. Other properties like spheroidogenesis and tumorogenesis have not been tested so far. MDA-MB-468 CD44high/CD24-/low was sorted according to their EGFR-expression in low and high expressing populations by means of flow cytometry. Subsequent analyses (FISH, qPCR) confirmed a positive correlation between EGFR expression and egfr gene copy numbers indicating a direct effect on gene expression which is in agreement with data from the literature for several cancer types basal like breast cancers included [1–3, 19–21].
A dynamic regain of egfr gene copies was observed for the low copy number subclone with time of cell culture. After a period of 12 - 14 weeks the cells regained completely the high egfr copy numbers. It might be assumed that this regain is caused by unequal segregation of chromosomes 7p as the cell cycle velocity of low and high copy number cells where determined nearly equal (Fig. 4a) even with a slight growth advantage of the low copy number cells. A possible mechanism of this process may be found in breakage-fusion-bridge (BFB)-cycles which can drive both, amplification [22, 23] as well as heterogeneity . BFB-cycles are initiated by chromosomal breakage of fragile sites distal to a selected gene  and based upon asymmetric segregation at mitosis. In consequence, the daughter cells will show up with different gene copy numbers, one with an increased copy number and the other with a diminished one. We were previously able to show such a fragile site breaking distal from the egfr locus  which might be the initiation of BFB-cycles. After that, chromosome-ends remain uncapped in the cells (Fig. 2) what gives some evidence for the assumption that recurrent BFB-cycles further promote amplifications and increase heterogeneity. Additionally the egfr amplifications are equal spaced in a ladder-like-structure (Fig. 2) and no double minutes containing the egfr gene were detectable. Similar findings could be shown in the human epidermoid cancer cell line A431 (own results, data not shown). Both cell lines show an intrachromosomal egfr amplification with the above mentioned findings but only A431 shows an additional polysomy of chr7. Egfr gene amplification reaches in both cell lines up to approx. 150 copies per cell. Due to the polysomy in A431 the gene copies per each chromosome do not reach the level which can be found in MDA-MB-468. These copy numbers are much higher than the ones which are seen in vivo and might thus be due to cell culture conditions. Nevertheless the structure of the egfr amplification in both cell lines is pointing towards BFB cycles as the more likely underlying mechanism for both the egfr amplification and the observed heterogeneity in vitro , and conceivably also in vivo.
In vivo, intratumoral genetic heterogeneity is not just only a well-known characteristic of numerous cancers but often confounds a precise diagnosis and leads to therapy resistance of the cancer. In this context the efficiency of antibodies targeting EGFR and small-molecule inhibitors impairing EGFR tyrosine kinase activity have to be discussed .
Nevertheless, we and other groups reported on the existence of a field cancerization in the human breast showing that the egfr aberrations were detected throughout an individual lobule or duct within histologically normal mammary epithelium with or without adjacent carcinoma [17, 27–30]. Such a model comprising stem/progenitor cells and field cancerization could account for phenotypic heterogeneity within individual mammary tumors, since tumors would be composed of tumor stem/progenitor cells as well as other more differentiated progeny generated through aberrant differentiation. In this context a supporting mechanism for generating heterogeneity within clonal populations might be specifically based on egfr amplifications in stem/progenitor cells due to chromosomal breakage at a fragile site at chromosome 7p15. It might be concluded from the data mentioned here that EGFR is tightly involved in normal and cancer stem/progenitor cell survival, conceivably as self-renewal. Therefore, aberrations of the egfr gene might be events that predispose cancer cells or even its precursors for longevity and therapy resistance.
The importance of the regain of egfr copy numbers is also shown by our data on erk and akt phosphorylation. The main downstream effectors of EGFR are the ras GTPase, initiating the phosphorylation of extracellular signal regulated kinase (ERK) and PI3-kinase/akt. Therefore, the expression level of EGFR constitutes the sensitivity of the cancer cells to extracellular signalling. This is rather diverse in the metastatic cascade a cancer cell has to traverse during progression of the disease and the settlement in low oxygen pressure tissues as bone marrow and the brain. The resulting signals regulate Ras-mediated transformation, Raf-mediated gene expression changes, and akt/mTOR phosphorylating activity which are crucial for growth, survival, and migration of cancer cells. Therefore, the regain of egfr copies might strongly contribute to the survival and outgrowth of disseminated cancer cells at the metastatic site .
A broad range of the egfr gene copy numbers leading to different EGFR expression levels can be found simultaneously under normal cell culture conditions in the breast cancer cell line MDA-MB-468 CD44+/CD24-/LOW. Interestingly, by flow cytometry sorted lower copy number clones showed regain of high copy numbers of egfr. This regain led to a heterogeneous population with synchronous high-, intermediate- and near-diploid copy number cells. The underlying mechanism might include in part breakage fusion bridge (BFB) cycles which can drive both, increase in gene copy numbers as well as genetic heterogeneity. We show here for the first time a dynamic copy number regain which might explain genetic heterogeneity and also might be involved in regulation processes in cancer cells which support survival and migration during cancer progression. Understanding of these mechanisms in vitro could deepen the understanding of processes in vivo and improve by this both diagnosis and therapy of the corresponding cancers.
This study was supported by grants from the Peter-and-Traudl-Engelhornstiftung (KA), the IMF Münster (KE220507), the Verein für Krebsforschung, Berlin (HB) and Deutsche Krebshilfe (10-1660-Br 4; BB).
- Lo KC, Stein LC, Panzarella JA, Cowell JK, Hawthorn L: Identification of genes involved in squamous cell carcinoma of the lung using synchronized data from DNA copy number and transcript expression profiling analysis. Lung Cancer. 2008, 59: 315-331. 10.1016/j.lungcan.2007.08.037.View ArticlePubMedGoogle Scholar
- Heidenblad M, Lindgren D, Veltman JA, Jonson T, Mahlamaki EH, Gorunova L, van Kessel AG, Schoenmakers EF, Hoglund M: Microarray analyses reveal strong influence of DNA copy number alterations on the transcriptional patterns in pancreatic cancer: implications for the interpretation of genomic amplifications. Oncogene. 2005, 24: 1794-1801. 10.1038/sj.onc.1208383.View ArticlePubMedGoogle Scholar
- Ruano Y, Mollejo M, Ribalta T, Fiano C, Camacho FI, Gomez E, de Lope AR, Hernandez-Moneo JL, Martinez P, Melendez B: Identification of novel candidate target genes in amplicons of Glioblastoma multiforme tumors detected by expression and CGH microarray profiling. Mol Cancer. 2006, 5: 39-10.1186/1476-4598-5-39.View ArticlePubMedPubMed CentralGoogle Scholar
- Hyman E, Kauraniemi P, Hautaniemi S, Wolf M, Mousses S, Rozenblum E, Ringner M, Sauter G, Monni O, Elkahloun A, et al: Impact of DNA amplification on gene expression patterns in breast cancer. Cancer Res. 2002, 62: 6240-6245.PubMedGoogle Scholar
- Hunter KW: Host genetics and tumour metastasis. Br J Cancer. 2004, 90: 752-755. 10.1038/sj.bjc.6601590.View ArticlePubMedPubMed CentralGoogle Scholar
- Torregrosa D, Bolufer P, Lluch A, Lopez JA, Barragan E, Ruiz A, Guillem V, Munarriz B, Conde JG: Prognostic significance of c-erbB-2/neu amplification and epidermal growth factor receptor (EGFR) in primary breast cancer and their relation to estradiol receptor (ER) status. Clinica Chimica Acta. 1997, 262: 99-119. 10.1016/S0009-8981(97)06542-X.View ArticleGoogle Scholar
- Nicholson RI, Gee JM, Harper ME: EGFR and cancer prognosis. Eur J Cancer. 2001, 37 (Suppl 4): S9-15. 10.1016/S0959-8049(01)00231-3.View ArticlePubMedGoogle Scholar
- Nicholson RI, McClelland RA, Gee JM, Manning DL, Cannon P, Robertson JF, Ellis IO, Blamey RW: Epidermal growth factor receptor expression in breast cancer: association with response to endocrine therapy. Breast Cancer Res Treat. 1994, 29: 117-125. 10.1007/BF00666187.View ArticlePubMedGoogle Scholar
- Nicolini A, Giardino R, Carpi A, Ferrari P, Anselmi L, Colosimo S, Conte M, Fini M, Giavaresi G, Berti P, et al: Metastatic breast cancer: an updating. Biomed Pharmacother. 2006, 60: 548-556. 10.1016/j.biopha.2006.07.086.View ArticlePubMedGoogle Scholar
- Ohgaki H, Dessen P, Jourde B, Horstmann S, Nishikawa T, Di Patre PL, Burkhard C, Schuler D, Probst-Hensch NM, Maiorka PC, et al: Genetic pathways to glioblastoma: a population-based study. Cancer Res. 2004, 64: 6892-6899. 10.1158/0008-5472.CAN-04-1337.View ArticlePubMedGoogle Scholar
- Pandita A, Aldape KD, Zadeh G, Guha A, James CD: Contrasting in vivo and in vitro fates of glioblastoma cell subpopulations with amplified EGFR. Genes Chromosomes Cancer. 2004, 39: 29-36. 10.1002/gcc.10300.View ArticlePubMedGoogle Scholar
- Martens T, Laabs Y, Gunther HS, Kemming D, Zhu Z, Witte L, Hagel C, Westphal M, Lamszus K: Inhibition of Glioblastoma Growth in a Highly Invasive Nude Mouse Model Can Be Achieved by Targeting Epidermal Growth Factor Receptor but not Vascular Endothelial Growth Factor Receptor-2. Clin Cancer Res. 2008, 14: 5447-5458. 10.1158/1078-0432.CCR-08-0147.View ArticlePubMedGoogle Scholar
- Sheridan C, Kishimoto H, Fuchs RK, Mehrotra S, Bhat-Nakshatri P, Turner CH, Goulet R, Badve S, Nakshatri H: CD44+/CD24- breast cancer cells exhibit enhanced invasive properties: an early step necessary for metastasis. Breast Cancer Res. 2006, 8: R59-10.1186/bcr1610.View ArticlePubMedPubMed CentralGoogle Scholar
- Croker AK, Goodale D, Chu J, Postenka C, Hedley BD, Hess DA, Allan AL: High aldehyde dehydrogenase and expression of cancer stem cell markers selects for breast cancer cells with enhanced malignant and metastatic ability. J Cell Mol Med. 2008, 13: 2236-2252. 10.1111/j.1582-4934.2008.00455.x.View ArticlePubMedGoogle Scholar
- Lin M, Wei LJ, Sellers WR, Lieberfarb M, Wong WH, Li C: dChipSNP: significance curve and clustering of SNP-array-based loss-of-heterozygosity data. Bioinformatics. 2004, 20: 1233-1240. 10.1093/bioinformatics/bth069.View ArticlePubMedGoogle Scholar
- Venkatraman ES, Olshen AB: A faster circular binary segmentation algorithm for the analysis of array CGH data. Bioinformatics. 2007, 23: 657-663. 10.1093/bioinformatics/btl646.View ArticlePubMedGoogle Scholar
- Tidow N, Boecker A, Schmidt H, Agelopoulos K, Boecker W, Buerger H, Brandt B: Distinct amplification of an untranslated regulatory sequence in the egfr gene contributes to early steps in breast cancer development. Cancer Res. 2003, 63: 1172-1178.PubMedGoogle Scholar
- Bohmer RM, Ellwart J: Cell cycle analysis by combining the 5-bromodeoxyuridine/33258 Hoechst technique with DNA-specific ethidium bromide staining. Cytometry. 1981, 2: 31-34. 10.1002/cyto.990020107.View ArticlePubMedGoogle Scholar
- Adelaide J, Finetti P, Bekhouche I, Repellini L, Geneix J, Sircoulomb F, Charafe-Jauffret E, Cervera N, Desplans J, Parzy D, et al: Integrated profiling of basal and luminal breast cancers. Cancer Res. 2007, 67: 11565-11575. 10.1158/0008-5472.CAN-07-2536.View ArticlePubMedGoogle Scholar
- Reis-Filho JS, Pinheiro C, Lambros MB, Milanezi F, Carvalho S, Savage K, Simpson PT, Jones C, Swift S, Mackay A, et al: EGFR amplification and lack of activating mutations in metaplastic breast carcinomas. J Pathol. 2006, 209: 445-453. 10.1002/path.2004.View ArticlePubMedGoogle Scholar
- Pintens S, Neven P, Drijkoningen M, Van BV, Moerman P, Christiaens MR, Smeets A, Wildiers H, Vanden BI: Triple negative breast cancer: a study from the point of view of basal CK5/6 and HER-1. J Clin Pathol. 2009, 62: 624-628. 10.1136/jcp.2008.061358.View ArticlePubMedGoogle Scholar
- Ciullo M, Debily MA, Rozier L, Autiero M, Billault A, Mayau V, El Marhomy S, Guardiola J, Bernheim A, Coullin P, et al: Initiation of the breakage-fusion-bridge mechanism through common fragile site activation in human breast cancer cells: the model of PIP gene duplication from a break at FRA7I. Hum Mol Genet. 2002, 11: 2887-2894. 10.1093/hmg/11.23.2887.View ArticlePubMedGoogle Scholar
- Hellman A, Zlotorynski E, Scherer SW, Cheung J, Vincent JB, Smith DI, Trakhtenbrot L, Kerem B: A role for common fragile site induction in amplification of human oncogenes. Cancer Cell. 2002, 1: 89-97. 10.1016/S1535-6108(02)00017-X.View ArticlePubMedGoogle Scholar
- Gisselsson D, Pettersson L, Hoglund M, Heidenblad M, Gorunova L, Wiegant J, Mertens F, Dal CP, Mitelman F, Mandahl N: Chromosomal breakage-fusion-bridge events cause genetic intratumor heterogeneity. Proc Natl Acad Sci USA. 2000, 97: 5357-5362. 10.1073/pnas.090013497.View ArticlePubMedPubMed CentralGoogle Scholar
- Pipiras E, Coquelle A, Bieth A, Debatisse M: Interstitial deletions and intrachromosomal amplification initiated from a double-strand break targeted to a mammalian chromosome. EMBO J. 1998, 17: 325-333. 10.1093/emboj/17.1.325.View ArticlePubMedPubMed CentralGoogle Scholar
- Moroni M, Veronese S, Benvenuti S, Marrapese G, Sartore-Bianchi A, Di NF, Gambacorta M, Siena S, Bardelli A: Gene copy number for epidermal growth factor receptor (EGFR) and clinical response to antiEGFR treatment in colorectal cancer: a cohort study. Lancet Oncol. 2005, 6: 279-286. 10.1016/S1470-2045(05)70102-9.View ArticlePubMedGoogle Scholar
- Deng G, Lu Y, Zlotnikov G, Thor AD, Smith HS: Loss of heterozygosity in normal tissue adjacent to breast carcinomas. Science. 1996, 274: 2057-2059. 10.1126/science.274.5295.2057.View ArticlePubMedGoogle Scholar
- Lakhani SR, Chaggar R, Davies S, Jones C, Collins N, Odel C, Stratton MR, O'Hare M: Genetic alterations in "normal" luminal and myoepithelial cells of the breast. J Pathol. 1999, 189: 496-503. 10.1002/(SICI)1096-9896(199912)189:4<496::AID-PATH485>3.0.CO;2-D.View ArticlePubMedGoogle Scholar
- Lakhani SR, Slack DN, Hamoudi RA, Collins N, Stratton MR, Sloane JP: Detection of allelic imbalance indicates that a proportion of mammary hyperplasia of usual type are clonal, neoplastic proliferations. Lab Invest. 1996, 74: 129-135.PubMedGoogle Scholar
- Forsti A, Louhelainen J, Soderberg M, Wijkstrom H, Hemminki K: Loss of heterozygosity in tumour-adjacent normal tissue of breast and bladder cancer. Eur J Cancer. 2001, 37: 1372-1380. 10.1016/S0959-8049(01)00118-6.View ArticlePubMedGoogle Scholar
- Pantel K, Brakenhoff RH: Dissecting the metastatic cascade. Nat Rev Cancer. 2004, 4: 448-456. 10.1038/nrc1370.View ArticlePubMedGoogle Scholar
- The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1471-2407/10/78/prepub
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