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Article ; Online: Mammary fibromatosis.

Glazebrook, Katrina N / Reynolds, Carol A

2009 Volume 193, Issue 3, Page(s) 856–860

Abstract: Objective: This article illustrates the imaging findings that have pathologic correlation and the clinical presentation of mammary fibromatosis.: Conclusion: Mammary fibromatosis is a rare, benign, nonmetastasizing stromal tumor. It presents ... ...

Abstract	Objective: This article illustrates the imaging findings that have pathologic correlation and the clinical presentation of mammary fibromatosis. Conclusion: Mammary fibromatosis is a rare, benign, nonmetastasizing stromal tumor. It presents clinically and radiologically as a palpable, spiculated, and locally invasive tumor that is suspicious for malignancy. MRI is ideal for evaluation of chest wall involvement. Although histologically benign, the tumor is locally aggressive and has significant recurrence rates. On occasion, recurrence may require radical surgery.
MeSH term(s)	Adult ; Breast Neoplasms/diagnosis ; Breast Neoplasms/diagnostic imaging ; Breast Neoplasms/pathology ; Breast Neoplasms/surgery ; Breast Neoplasms, Male/diagnosis ; Breast Neoplasms, Male/diagnostic imaging ; Breast Neoplasms, Male/pathology ; Breast Neoplasms, Male/surgery ; Diagnosis, Differential ; Female ; Fibroma/diagnosis ; Fibroma/diagnostic imaging ; Fibroma/pathology ; Fibroma/surgery ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Retrospective Studies ; Ultrasonography, Mammary
Language	English
Publishing date	2009-09
Publishing country	United States
Document type	Journal Article
ZDB-ID	82076-3
ISSN	1546-3141 ; 0361-803X ; 0092-5381
ISSN (online)	1546-3141
ISSN	0361-803X ; 0092-5381
DOI	10.2214/AJR.08.1892
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Article ; Online: Collision tumors with synchronous presentation of breast carcinoma and lymphoproliferative disorders in the axillary nodes of patients with newly diagnosed breast cancer: a case series.

Wahner-Roedler, Dietlind L / Reynolds, Carol A / Boughey, Judy C

Clinical breast cancer

2011 Volume 11, Issue 1, Page(s) 61–66

Abstract: Although occurrence of a second tumor is a well-recognized phenomenon in patients with a treated malignancy, simultaneous presentation with a second primary malignancy ("collision tumor") is rare in patients with breast cancer. We report a series of 7 ... ...

Abstract	Although occurrence of a second tumor is a well-recognized phenomenon in patients with a treated malignancy, simultaneous presentation with a second primary malignancy ("collision tumor") is rare in patients with breast cancer. We report a series of 7 patients who were undergoing axillary nodal staging of a newly diagnosed breast cancer. Six patients were found to have collision tumors in their axillary lymph nodes consisting of metastatic breast cancer and a previously unknown lymphoproliferative disorder. In 1 additional patient, a lymph node biopsy of a palpable axillary node resulted in the diagnosis of metastatic breast cancer and lymphoma. Awareness and diagnosis of such collision tumors will lead to appropriate management of each malignancy.
MeSH term(s)	Aged ; Aged, 80 and over ; Axilla ; Breast Neoplasms/diagnosis ; Breast Neoplasms/surgery ; Female ; Humans ; Lymph Nodes/pathology ; Lymph Nodes/surgery ; Lymphatic Metastasis ; Lymphoproliferative Disorders/diagnosis ; Lymphoproliferative Disorders/surgery ; Middle Aged ; Neoplasms, Multiple Primary/diagnosis ; Neoplasms, Multiple Primary/surgery
Language	English
Publishing date	2011-03
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	2106734-X
ISSN	1938-0666 ; 1526-8209
ISSN (online)	1938-0666
ISSN	1526-8209
DOI	10.3816/CBC.2011.n.010
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Article: Sentinel lymph node surgery for staging of breast carcinoma in patients with lymphoproliferative disease.

Dy, Benzon M / Reynolds, Carol A / Wahner-Roedler, Dietlind L / Boughey, Judy C

The American surgeon

2010 Volume 76, Issue 12, Page(s) 1423–1425

Abstract: There are few reports confirming the validity of sentinel lymph biopsy in patients with a background of lymphoproliferative disease. We reviewed nine cases of women who underwent sentinel lymph node (SLN) surgery for staging of primary breast cancer with ...

Abstract	There are few reports confirming the validity of sentinel lymph biopsy in patients with a background of lymphoproliferative disease. We reviewed nine cases of women who underwent sentinel lymph node (SLN) surgery for staging of primary breast cancer with a diagnosis of lymphoproliferative disease. SLN identification rate was 100 per cent with a background of lymphoma in the sentinel node in eight of the nine patients. With a mean follow-up of 37 months, there have been no axillary recurrences in any of these patients. These cases illustrate that SLN staging is feasible and provides axillary staging information in women with breast cancer despite synchronous lymphoproliferative disease.
MeSH term(s)	Aged ; Aged, 80 and over ; Breast Neoplasms/epidemiology ; Breast Neoplasms/pathology ; Comorbidity ; Female ; Humans ; Lymphoproliferative Disorders/epidemiology ; Middle Aged ; Neoplasm Staging ; Retrospective Studies ; Sentinel Lymph Node Biopsy
Language	English
Publishing date	2010-12
Publishing country	United States
Document type	Journal Article
ZDB-ID	202465-2
ISSN	1555-9823 ; 0003-1348
ISSN (online)	1555-9823
ISSN	0003-1348
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Article ; Online: Invasive micropapillary carcinoma of the breast: imaging features with clinical and pathologic correlation.

Jones, Katie N / Guimaraes, Luis S / Reynolds, Carol A / Ghosh, Karthik / Degnim, Amy C / Glazebrook, Katrina N

AJR. American journal of roentgenology

2013 Volume 200, Issue 3, Page(s) 689–695

Abstract: Objective: The purpose of this article is to present imaging findings of invasive ductal carcinoma with micropapillary features with clinical and pathologic correlation.: Materials and methods: We retrospectively searched our institution's surgical ... ...

Abstract	Objective: The purpose of this article is to present imaging findings of invasive ductal carcinoma with micropapillary features with clinical and pathologic correlation. Materials and methods: We retrospectively searched our institution's surgical pathology database for patients with pathologically proven invasive ductal carcinoma with micropapillary features. Forty-one patients with images available for review were included in the study. Mammographic, sonographic, and MRI findings were assessed using the American College of Radiology's BI-RADS lexicon. Molecular breast imaging findings were reviewed using a molecular breast imaging lexicon. Imaging findings were correlated with clinical presentation and pathologic findings. Results: Mammographically, the most common finding was an irregular spiculated mass. Sonographically, the most common finding was an irregular hypoechoic mass with spiculated margins and posterior acoustic shadowing. With MRI, the most common finding was an irregular mass with washout kinetics, but we also observed diffuse heterogeneous nonmasslike enhancement throughout the breast. Molecular breast imaging was available for one patient and showed multicentric radiotracer uptake. Analysis of 39 pathologic specimens showed 27 (69%) with angiolymphatic invasion. Axillary nodal metastases were present in 23 patients (59%), nine (23%) with extranodal extension. Conclusion: The imaging features of invasive ductal carcinoma of the breast with micropapillary features typically were highly suggestive of malignancy. The malignancies were strongly associated with lymphovascular invasion and lymph node metastases. Radiologists should be aware of the imaging features of this unusual variant and should consider axillary sonography if this entity is found in a core needle biopsy specimen.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Breast Neoplasms/diagnosis ; Breast Neoplasms/pathology ; Carcinoma, Papillary/diagnosis ; Carcinoma, Papillary/pathology ; Female ; Humans ; Mammography/methods ; Middle Aged ; Neoplasm Invasiveness ; Reproducibility of Results ; Sensitivity and Specificity ; Statistics as Topic
Language	English
Publishing date	2013-03
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	82076-3
ISSN	1546-3141 ; 0361-803X ; 0092-5381
ISSN (online)	1546-3141
ISSN	0361-803X ; 0092-5381
DOI	10.2214/AJR.12.8512
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Article ; Online: Preoperative axillary imaging with percutaneous lymph node biopsy is valuable in the contemporary management of patients with breast cancer.

Hieken, Tina J / Trull, Brent C / Boughey, Judy C / Jones, Katie N / Reynolds, Carol A / Shah, Sejal S / Glazebrook, Katrina N

Surgery

2013 Volume 154, Issue 4, Page(s) 831–8; discussion 838–40

Abstract: Background: ACOSOG Z11 and other studies showing little benefit to axillary dissection (ALND) for early-stage breast cancers with limited nodal disease have led to questioning the value of preoperative axillary imaging ± ultrasound-guided needle biopsy ( ...

Abstract	Background: ACOSOG Z11 and other studies showing little benefit to axillary dissection (ALND) for early-stage breast cancers with limited nodal disease have led to questioning the value of preoperative axillary imaging ± ultrasound-guided needle biopsy (USNB). Data are lacking on the value of this approach in identifying cases that fall outside Z11 guidelines. Methods: We studied 988 consecutive patients with invasive breast cancers who underwent operation including axillary surgery in 2010-2011. Results: Preoperative axillary ultrasonography (AUS) was performed in 92% and breast/axillary magnetic resonance imaging (MRI) in 51%; 82 (33.5%) of 245 patients with suspicious lymph nodes (LN) were USNB-positive. Regarding nodal status, AUS, MRI, and USNB had negative and positive predictive values of 78%, 76%, 70% and 54%, 58%, 100%, respectively. AUS/MRI visualization of one versus multiple abnormal LNs visualized predicted >2LN+ on final pathology (13.5%/15.1% % vs 30.8%/32.6%, P < .009). Among USNB-LN+ T1/T2 patients, 51.6% had 1-2 LN+ while 60% with multiple and 31% with one AUS-abnormal LN(s) had > 2LN+, P = .001. Conclusion: In our contemporary series, preoperative AUS±USNB streamlined surgical care for 29% of node-positive patients. Two-thirds of T1/T2 USNB-LN+ patients with multiple AUS-suspicious LNs had >2LN+, suggesting they should undergo ALND without SLNB. AUS±USNB helps identify node-positive breast cancer patients who fall outside Z11 guidelines.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Axilla ; Biopsy, Needle ; Breast Neoplasms/pathology ; Breast Neoplasms/surgery ; Female ; Humans ; Lymph Nodes/pathology ; Lymphatic Metastasis ; Magnetic Resonance Imaging ; Middle Aged ; Ultrasonography, Interventional
Language	English
Publishing date	2013-10
Publishing country	United States
Document type	Journal Article
ZDB-ID	202467-6
ISSN	1532-7361 ; 0039-6060
ISSN (online)	1532-7361
ISSN	0039-6060
DOI	10.1016/j.surg.2013.07.017
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Article: Recurrent cardiac calcific amorphous tumor: the CAT had a kitten.

Fealey, Michael E / Edwards, William D / Reynolds, Carol A / Pellikka, Patricia A / Dearani, Joseph A

Cardiovascular pathology : the official journal of the Society for Cardiovascular Pathology

2007 Volume 16, Issue 2, Page(s) 115–118

Abstract: Background: Cardiac calcified amorphous tumors (CATs) represent degenerating intracavitary mural thrombi that can mimic neoplasms and cause symptoms due to embolization or obstruction. Surgical excision is generally curative. Postoperative recurrences ... ...

Abstract	Background: Cardiac calcified amorphous tumors (CATs) represent degenerating intracavitary mural thrombi that can mimic neoplasms and cause symptoms due to embolization or obstruction. Surgical excision is generally curative. Postoperative recurrences have not been previously reported. Methods: Medical, surgical, and pathological records were reviewed in a patient who had undergone removal of a recurrent cardiac CAT. Results: The patient, now a 23-year-old woman, had undergone excision of the initial right ventricular mass on November 4, 2003, because of recent pulmonary embolization. Extensive clinical evaluation showed no coagulation abnormality. Follow-up postoperative echocardiograms showed incomplete excision and subsequent enlargement. As a result, the recurrent mass was excised on March 14, 2006. Microscopic evaluation showed degenerating and focally calcifying thrombus, without neoplastic features. Conclusion: Cardiac CAT may recur and enlarge following surgical excision. Periodic postoperative follow-up with cardiac imaging studies may be indicated, particularly if there is evidence of incomplete excision.
MeSH term(s)	Adult ; Calcinosis/pathology ; Calcinosis/surgery ; Cardiomyopathies/pathology ; Cardiomyopathies/surgery ; Female ; Humans ; Recurrence ; Reoperation ; Thrombosis/pathology ; Thrombosis/surgery ; Treatment Outcome
Language	English
Publishing date	2007-03
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	1134600-0
ISSN	1054-8807
ISSN	1054-8807
DOI	10.1016/j.carpath.2006.09.002
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Article: Primary nonphylloides breast sarcomas.

Blanchard, D Kay / Reynolds, Carol A / Grant, Clive S / Donohue, John H

American journal of surgery

2003 Volume 186, Issue 4, Page(s) 359–361

Abstract: Background: The prevalence of primary breast sarcoma is low, occurring in fewer than 1% of women with breast malignancies. The purpose of this study was to examine the presentation, treatment, and prognosis of patients presenting with these neoplasms.!## ...

Abstract	Background: The prevalence of primary breast sarcoma is low, occurring in fewer than 1% of women with breast malignancies. The purpose of this study was to examine the presentation, treatment, and prognosis of patients presenting with these neoplasms. Methods: This was a retrospective review of patients with a primary breast sarcoma treated at Mayo Clinic, Rochester, Minnesota, between 1975 and 2001. Follow-up information was obtained. Results: Of the 55 patients, 17 had breast-conserving therapy and 38 women had mastectomy. The mean patient age at presentation was 52 years (range 22 to 82). The types of sarcoma included angiosarcoma (18), malignant fibrous histiocytoma (11), stromal sarcoma (8), liposarcoma (4), leiomyosarcoma (4), dermatofibrosarcoma protuberans (4), osteosarcoma (3), fibrosarcoma (2), and rhabdomyosarcoma (1). Follow-up information was available for 53 patients, with a mean follow-up of 81 months. Twenty-nine of 53 patients (55%) developed recurrent sarcoma, and 23 patients (43%) died of their disease. Twenty-seven patients had no evidence of recurrence, and 3 patients were alive with disease at last follow-up. Overall median survival of patients with breast sarcoma was 58 months. Patients with angiosarcoma had a poorer outcome than other sarcoma patients. Twelve of 18 patients (67%) died of angiosarcoma, compared with 11 of 32 patients (34%) of all other sarcoma patients combined. Of 34 patients who did not receive adjuvant chemotherapy or radiation, 13 died of their disease (38%), as compared with 10 of 16 patients (63%) who did receive adjuvant therapy. Conclusions: While primary nonphylloides breast sarcomas are rare tumors, their treatment and prognosis are poor. Adjuvant chemotherapy and radiation did not improve survival in this report. Surgical extirpation remains the only effective treatment.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Breast Neoplasms/diagnosis ; Breast Neoplasms/mortality ; Breast Neoplasms/surgery ; Female ; Humans ; Middle Aged ; Retrospective Studies ; Sarcoma/diagnosis ; Sarcoma/mortality ; Sarcoma/surgery ; Survival Rate
Language	English
Publishing date	2003-10-02
Publishing country	United States
Document type	Journal Article
ZDB-ID	2953-1
ISSN	1879-1883 ; 0002-9610
ISSN (online)	1879-1883
ISSN	0002-9610
DOI	10.1016/s0002-9610(03)00269-1
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Article ; Online: Evaluation of the Tyrer-Cuzick (International Breast Cancer Intervention Study) model for breast cancer risk prediction in women with atypical hyperplasia.

Boughey, Judy C / Hartmann, Lynn C / Anderson, Stephanie S / Degnim, Amy C / Vierkant, Robert A / Reynolds, Carol A / Frost, Marlene H / Pankratz, V Shane

Journal of clinical oncology : official journal of the American Society of Clinical Oncology

2010 Volume 28, Issue 22, Page(s) 3591–3596

Abstract: Purpose: Accurate breast cancer risk assessment is vital to personalize screening and risk reduction strategies. Women with atypical hyperplasia have a four-fold higher risk of breast cancer. We evaluated the performance of the Tyrer-Cuzick model, which ...

Abstract	Purpose: Accurate breast cancer risk assessment is vital to personalize screening and risk reduction strategies. Women with atypical hyperplasia have a four-fold higher risk of breast cancer. We evaluated the performance of the Tyrer-Cuzick model, which was designed to predict 10-year risk of breast cancer development, in a well-defined cohort of women with atypia. Patients and methods: The Mayo Benign Breast Disease cohort includes 9,376 women who had a benign breast biopsy between 1967 and 1991. Among those, 331 women with atypia were identified by our study pathologists. Risk factor data for the Tyrer-Cuzick model were collated for each woman and used to predict individual risk of developing invasive breast cancer within 10 years. Results: Over a median follow-up of 14.6 years, 64 (19%) of the 331 women developed invasive breast cancer. In the first 10 years after biopsy, 31 women developed invasive breast cancer whereas the Tyrer-Cuzick model predicted 58.9. The observed-to-predicted ratio was 0.53 (95% CI, 0.37 to 0.75). The concordance statistic was 0.540, revealing that the Tyrer-Cuzick model did not accurately distinguish, on an individual level, between women who developed invasive breast cancer and those who did not. Conclusion: The Tyrer-Cuzick model significantly overestimated risk of breast cancer for women with atypia, and individual risk estimates showed poor concordance between predicted risk and invasive breast cancer development. Thus, we cannot recommend the use of the Tyrer-Cuzick model to predict 10-year breast cancer risk in women with atypical hyperplasia.
MeSH term(s)	Aged ; Breast/pathology ; Breast Neoplasms/epidemiology ; Family Health ; Female ; Follow-Up Studies ; Humans ; Hyperplasia/complications ; Middle Aged ; Models, Statistical ; Predictive Value of Tests ; Risk Assessment/methods
Language	English
Publishing date	2010-07-06
Publishing country	United States
Document type	Evaluation Study ; Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	604914-x
ISSN	1527-7755 ; 0732-183X
ISSN (online)	1527-7755
ISSN	0732-183X
DOI	10.1200/JCO.2010.28.0784
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Article ; Online: Primary and secondary angiosarcoma of the breast: the Mayo Clinic experience.

Scow, Jeffrey S / Reynolds, Carol A / Degnim, Amy C / Petersen, Ivy A / Jakub, James W / Boughey, Judy C

Journal of surgical oncology

2010 Volume 101, Issue 5, Page(s) 401–407

Abstract: Background and objectives: Angiosarcoma of the breast can be divided into primary and secondary. The objective was to determine clinicopathologic factors associated with breast angiosarcoma and to compare primary versus secondary angiosarcoma.: ... ...

Abstract	Background and objectives: Angiosarcoma of the breast can be divided into primary and secondary. The objective was to determine clinicopathologic factors associated with breast angiosarcoma and to compare primary versus secondary angiosarcoma. Methods: Breast angiosarcoma cases at Mayo Clinic from 1960 to 2008 were identified. Clinicopathologic factors were reviewed. Characteristics of primary and secondary angiosarcoma were compared. Results: Twenty-seven cases of primary angiosarcoma and 14 cases of secondary angiosarcoma were identified. The median age of primary angiosarcoma patients was lower than that of secondary angiosarcoma--43 years versus 73 years (P < 0.0001). Primary angiosarcoma more frequently presented with a mass, whereas secondary angiosarcoma presented with a rash (P < 0.0001). Median time from radiation to secondary angiosarcoma diagnosis was 6.8 years. Median tumor size was 7.0 cm for primary angiosarcoma and 5.0 cm for secondary angiosarcoma (P = 0.7). Tumors were high grade in 33% of primary angiosarcoma and 82% of secondary angiosarcoma (P = 0.02). Five-year survival for primary and secondary angiosarcoma was 46% and 69%, respectively (P = 0.8). Conclusion: Primary angiosarcoma occurs in younger patients than secondary and more frequently presents with a mass. Mastectomy is the mainstay of treatment for breast angiosarcoma. Breast angiosarcoma is a rare malignancy with poor long-term prognosis.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Breast Neoplasms/pathology ; Breast Neoplasms/surgery ; Female ; Hemangiosarcoma/pathology ; Hemangiosarcoma/surgery ; Humans ; Mastectomy ; Mastectomy, Segmental ; Middle Aged ; Neoplasms, Second Primary/pathology ; Retrospective Studies
Language	English
Publishing date	2010-04-01
Publishing country	United States
Document type	Journal Article
ZDB-ID	82063-5
ISSN	1096-9098 ; 0022-4790
ISSN (online)	1096-9098
ISSN	0022-4790
DOI	10.1002/jso.21497
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Article ; Online: Impact of American Society of Clinical Oncology/College of American Pathologists guideline recommendations on HER2 interpretation in breast cancer.

Shah, Sejal S / Ketterling, Rhett P / Goetz, Matthew P / Ingle, James N / Reynolds, Carol A / Perez, Edith A / Chen, Beiyun

Human pathology

2010 Volume 41, Issue 1, Page(s) 103–106

Abstract: Accurate assessment of human epidermal growth factor receptor 2 is critical for the management of patients with breast cancer. We set out to study the impact of the 2007 American Society of Clinical Oncology/College of American Pathologists guidelines on ...

Abstract	Accurate assessment of human epidermal growth factor receptor 2 is critical for the management of patients with breast cancer. We set out to study the impact of the 2007 American Society of Clinical Oncology/College of American Pathologists guidelines on the interpretation of human epidermal growth factor receptor 2 IHC results and its correlation with fluorescence in situ hybridization results. Invasive breast carcinomas with IHC HercepTest 3+ were retrieved from the archive of Mayo Clinic Rochester. The human epidermal growth factor receptor 2 slides were rereviewed, and results were recorded as percentage of invasive tumor cells with 3+, 2+, 1+, and 0 staining intensity. Human epidermal growth factor receptor 2 gene amplification by fluorescence in situ hybridization was performed on all tumors with 3+ staining in 70% or less of tumor cells. Of the 141 cases studied, 12 cases showed intense membrane staining in 11% to 30% of the invasive tumor cells and would have been scored as 2+ according to the new American Society of Clinical Oncology/College of American Pathologists guidelines. Of these 12 cases, 6 were positive for human epidermal growth factor receptor 2 gene amplification by fluorescence in situ hybridization (ratio >2.2), 4 cases were negative (HER2/CEP17 ratio of < 1.8), and 2 cases were equivocal (ratio of 1.8-2.2). One human epidermal growth factor receptor 2-positive case showed dramatic intratumoral heterogeneity with high-level amplification (ratio of 12.2) in the IHC 3+ area and no amplification (ratio of 1.0) in the IHC 1+/2+ areas. The 2007 American Society of Clinical Oncology/College of American Pathologists guidelines down-scored 2.8% of tumors from human epidermal growth factor receptor 2-positive (IHC 3+) to human epidermal growth factor receptor 2-negative (IHC 2+ equivocal and fluorescence in situ hybridization negative) in this study. Clinical studies are needed to determine whether the updated guidelines are better at predicting response to anti-human epidermal growth factor receptor 2 therapy.
MeSH term(s)	Biomarkers, Tumor/metabolism ; Breast Neoplasms/diagnosis ; Breast Neoplasms/genetics ; Breast Neoplasms/metabolism ; Carcinoma, Ductal, Breast/diagnosis ; Carcinoma, Ductal, Breast/genetics ; Carcinoma, Ductal, Breast/metabolism ; Cell Count ; DNA, Neoplasm/analysis ; Female ; Gene Amplification ; Humans ; In Situ Hybridization, Fluorescence ; Medical Oncology/standards ; Neoplasm Invasiveness ; Pathology, Clinical/standards ; Practice Guidelines as Topic ; Receptor, ErbB-2/genetics ; Receptor, ErbB-2/metabolism
Chemical Substances	Biomarkers, Tumor ; DNA, Neoplasm ; ERBB2 protein, human (EC 2.7.10.1) ; Receptor, ErbB-2 (EC 2.7.10.1)
Language	English
Publishing date	2010-01
Publishing country	United States
Document type	Journal Article
ZDB-ID	207657-3
ISSN	1532-8392 ; 0046-8177
ISSN (online)	1532-8392
ISSN	0046-8177
DOI	10.1016/j.humpath.2009.07.001
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