The equivocally amplified HER2 FISH result on breast core biopsy: indications for further sampling do affect patient management.

Abstract:

:To our knowledge, there are no universally accepted, evidence-based guidelines for how to resolve the HER2 status of tumors demonstrating equivocal amplification. The present study was based on 17 breast core biopsy specimens demonstrating invasive carcinoma with equivocal HER2 amplification, defined as an HER2/chromosome 17 centromere ratio of 1.8 to 2.2. Each case had a corresponding resection specimen, on which HER2 immunohistochemical and repeated fluorescence in situ hybridization analyses were performed. A definitive change in HER2 status based on the resection specimen occurred in 10 (59%) of 17 cases, with 4 patients (24%) becoming eligible for trastuzumab therapy and 6 (35%) triaged as ineligible. These results suggest that genetic and protein expression heterogeneity exists in tumors that show low-level HER2 gene copy numbers. For the purposes of uniform clinical management, HER2 status should be evaluated on a larger tumor sample if the core biopsy specimen demonstrates an equivocal result. These results support the recent American Society of Clinical Oncology/College of American Pathologists recommendations for further testing in cases with equivocal HER2 results.

journal_name

Am J Clin Pathol

authors

Striebel JM,Bhargava R,Horbinski C,Surti U,Dabbs DJ

doi

10.1309/KFKDNK8CENVN24VU

subject

Has Abstract

pub_date

2008-03-01 00:00:00

pages

383-90

issue

3

eissn

0002-9173

issn

1943-7722

pii

481W311587U2J354

journal_volume

129

pub_type

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