Publication: HER-2 status determination in breast carcinomas. A practical approach
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Date
2006
Authors
Garcia-Caballero, Tomas ; Menéndez, M.D. ; Vázquez-Boquete, A. ; Gallego, R. ; Forteza, J. ; Fraga, M.
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Publisher
Murcia : F. Hernández
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DOI
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info:eu-repo/semantics/article
Description
Abstract
Accurate evaluation of HER-2 status is
crucial in the selection of breast carcinoma patients for
trastuzumab (Herceptin) treatment. Various laboratory
methods have been used for this purpose. The aim of the
present work was to analyse the results obtained in the
routine practice by immunohistochemistry (IHC) and
fluorescence in situ hybridization (FISH) in
determination of HER-2 status. Five hundred and three
cases of breast invasive ductal carcinoma were selected
to analyse the HER-2 overexpression by
immunohistochemistry (HercepTest, Dako). HercepTest
2+ equivocal cases (60) were studied by FISH
(PathVysion, Vysis) to determine HER-2 gene
amplification. HER-2 overexpression determined by
Herceptest was shown in 97/503 cases (19%). FISH
performed on equivocal cases demonstrated HER-2
amplification in 11/60 tumours (18%). IHC and FISH
together showed HER-2 overexpression / gene
amplification in 21% of breast invasive carcinomas.
Immunohistochemical determination of HER-2 status
represents an easy and standardized method that (in
contrast to FISH) can be performed in all pathology
laboratories without need of any special microscope and enabling to check the morphologic features of the cells
analysed. However, in order to assure the reliability of
the results, standardization of fixation protocols,
automation of the immunohistochemical procedure, and
training of pathologists in the interpretation of the results
(scoring criteria) should be a priority. Equivocal
HercepTest cases must be analysed by FISH preferably
in a reference laboratory.
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