Comparison of immunohistochemical and fluorescence in situ hybridization assessment of HER-2 status in routine practice

Because HER-2 expression in invasive carcinoma of the breast has well-documented ramifications for treatment and prognosis, accurate assessment of HER-2 status is critical. Comparative studies have shown high concordance rates between immunohistochemical analysis and fluorescence in situ hybridizati...

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Bibliographic Details
Published in:American journal of clinical pathology 2005-05, Vol.123 (5), p.766-770
Main Authors: DOLAN, Michelle, SNOVER, Dale
Format: Article
Language:English
Subjects:
Biological and medical sciences
Biomarkers, Tumor - analysis
Breast Neoplasms - chemistry
Breast Neoplasms - genetics
Breast Neoplasms - pathology
Carcinoma, Ductal, Breast - chemistry
Carcinoma, Ductal, Breast - genetics
Carcinoma, Ductal, Breast - pathology
Carcinoma, Lobular - chemistry
Carcinoma, Lobular - genetics
Carcinoma, Lobular - pathology
Humans
Immunohistochemistry - methods
In Situ Hybridization, Fluorescence
Investigative techniques, diagnostic techniques (general aspects)
Medical sciences
Observer Variation
Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques
Receptor, ErbB-2 - analysis
Receptor, ErbB-2 - genetics
Reproducibility of Results
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Summary:Because HER-2 expression in invasive carcinoma of the breast has well-documented ramifications for treatment and prognosis, accurate assessment of HER-2 status is critical. Comparative studies have shown high concordance rates between immunohistochemical analysis and fluorescence in situ hybridization (FISH) in cases with immunohistochemical scores of 0 or 1+ (negative) and 3+ (strongly positive) and low concordance rates among cases with immunohistochemical scores of 2+. The present study was performed to determine concordance rates in a setting more representative of routine clinical practice, in which multiple pathologists submit specimens to a single cytogenetics referral laboratory. We found a higher rate of discordance between immunohistochemical analysis and FISH (approximately 92%) in the groups with immunohistochemical scores of 2+ than reported in other studies. These results strongly support the practice of performing FISH in all cases with immunohistochemical scores of 2+, particularly in routine practice, in which interobserver variability in immunohistochemical scoring among multiple pathologists is likely to be high.
ISSN:0002-9173
1943-7722
DOI:10.1309/Q0DGL26RUCK1K5EV