Abstract
Background: HER-2/neu immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH) results guide breast cancer therapy; however, few studies compared the results and no published studies have correlated them with patient outcome.
Methods and Results: We compared results, cost, and turnaround time in 117 archival, invasive breast carcinomas and compared 50-month survival in 65 of these cases using commercial HER-2/neu IHC and FISH assays. Twenty-one of 112 FISH (19%) and 33 of 117 IHC cases (28%) were positive. Concordance was high overall (88%; 98 of 112 cases) and in IHC 3+ cases (88%; 14 of 16 cases) but low in IHC 2+ cases (35%; six of 17 cases). Survival correlated with IHC results in 3+ cases (P =.02) and FISH cases with signal ratio greater than 4.0 (P =.03), but not in IHC 2+ cases (P =.7). Cost and turnaround time were greater for FISH.
Conclusion: IHC is appropriate for initial HER-2/neu assessment; however, patients with tumors scored less than 3+, particularly those interpreted as 2+, would benefit from FISH to more accurately assess HER-2/neu status and avoid inaccurate prognostication and inappropriate treatment.
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Kakar, S., Puangsuvan, N., Stevens, J.M. et al. HER-2/neu Assessment in Breast Cancer by Immunohistochemistry and Fluorescence In Situ Hybridization: Comparison of Results and Correlation With Survival. Molecular Diagnosis 5, 199–207 (2000). https://doi.org/10.1007/BF03262077
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DOI: https://doi.org/10.1007/BF03262077