MYC and cancer: Reports of a weak correlation between c-MYC copy number and protein expression in cancer are common, and have been described in breast, pancreatic, bladder and colon disease.26, 27, 28, 29 Expression of c-MYC is regulated by multiple pathways and is known to be highly regulated by cell cycle state (quiescence/proliferation), irrespective of whether there is gene amplification.30, 31 As such, cases in which c-MYC protein expression does not increase with gene copy number could indicate a low proliferative index or mechanisms disrupting transcription/protein stability.