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Cancer care is increasingly delivered by multidisciplinary teams. Cath Taylor and colleagues argue that stronger evidence is needed of their effectiveness

Evaluation of evidence for the effectiveness of multidisciplinary team working in cancer care. The implementation of multidisciplinary teams (MDT) in UK cancer services is described, and research into their use is reviewed. Impact on clinical outcomes, decision making, views of health professionals and the patient experience of care are considered. [(BNI unique abstract)] 31 references

Abnormalities in p53 gene expression have been implicated in many inherited and sporadic forms of malignancies in humans. Immunohistochemical staining using monoclonal antibody D0-7 for the p53 protein expression was performed in 81 cases of pure DCIS, 14 benign breast lesions and 2 cases with normal breast tissue. Expression of p53 protein was detected in 15 (18.5%) cases of pure DCIS. Thirteen (25%) of the 52 comedo type DCIS showed p53 protein expression compared with 2 (6.9%) of the 29 non-comedo types (P < 0.02). p53 protein expression was also associated with high nuclear grade (P < 0.001) and high mitotic index (P < 0.05). The pattern of p53 protein staining was diffuse in one comedo type DCIS, regional in 6 comedo types, and focal in the remaining 8 cases (6 comedo type and 2 micropapillary type DCIS). The patient with comedo type DCIS showing diffuse staining has a family history of breast cancer in the first and second degree relatives (sister and maternal aunt). Clinical follow-up data was available in 52 cases. Follow-up period ranged from 9 to 55 months. Three patients, who were primarily treated by local excision, have had a documented local recurrence in the form of residual tumor within a short interval of 5 to 11 months. In all these three patients both the original and the recurrent tumors are negative for p53 protein expression. The difference in the local recurrence rate between p53 positive (0/15) and p53 negative (3/37) cased does not reach statistical significance (p > 0.05). We interpret that the local tumor recurrence in these three cases within a short period after primary excision is due to the presence of residual tumor at the excision site and is independent of the p53 gene alteration. It is concluded that p53 protein expression in DCIS is associated with comedo subtype, high nuclear grade, and high mitotic index, and is a promising new parameter to evaluate the cellular biology and prognosis of DCIS.

The SpaceShipOne spacecraft may have won the US$10-million X- Prize for private space flight last week, but Brian Feeney, head of rival company the daVinci Project, is not worried. Mr. Feeney believes his team has an advantage over Scaled Composites, the California-based company behind SpaceShipOne. So-called spaceports are vying to become the hub of choice for lift-offs. The Mojave spaceport in California is SpaceShipOne's base, but the X-Prize Cup will take place at the Southwest Regional Spaceport in New Mexico. Although Virgin will start flying from Mojave, it hopes to move on first to Florida and then to unspecified locations in Britain, Singapore and Australia. Color Photo: Robert Galbraith, Reuters / SpaceShip One sits on the underside of pilot airplane \"White Knight\" as they prepare for liftoff last month. Space tourism, once it is launched, will initially involve suborbital flights. In future, however, entrepreneurs envisage space hotels and even moon holidays.; Color Photo: Robert Galbraith, Reuters / Pilot Mike Melvill celebrates atop SpaceShip One following touchdown at the Mojave Airport Civilian Aerospace Test Center in Mojave, Calif., last month. The goal is to eventually carry paying passengers into space.