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- Title
Breast cancer human epidermal growth factor receptor 2 testing - the Manitoba experience.
- Authors
Klein, J.; Fischer, G.; Gomez, J. D.; Phillipot-Rosset, M.
- Abstract
Objective: In contrast to Fluorescence In-situ hybridization, Dual-ISH bright-field examination allows more readily assessable morphology for identification of carcinoma cells, and permanent slide archiving. Diagnostic Services Manitoba began performing Her2 testing by Dual ISH in 2012. We review our Her2 data from the past two years to determine positivity rates. Method: Data was analyzed from January 1, 2014 to December 31, 2015. Excision specimens (cores when requested) were initially assessed by immunohistochemistry for Her2 protein over-expression, using the 2013 ASCO/CAP guideline. Cases scored IHC 2+ were tested by Dual-ISH. Unresolved equivocal cases were tested by FISH at a reference laboratory. Results: There were 1952 breast cancer specimens (1604 excisions, 221 core biopsies, 127 metastases). By IHC, excision specimens were 9.5% positive, 50.0% negative, 39.0% equivocal, and 1.5% indeterminate; and core biopsies 16.3% positive, 38.9% negative, 42.5 % equivocal, and 1.4% indeterminate. Dual-ISH on equivocal excisions (625) was positive in 19.2%, negative in 73.4%, equivocal in 9.1%, and indeterminate in 2.1%; and on core biopsies (94) was positive in 12.8%, negative in 69.1%, equivocal in 16.0% and also indeterminate in 2.1%. Of cases sent for FISH, 31.8% were interpreted as positive, 36.4% as negative, and 31.8% as equivocal. The Her2 positivity rate for primary breast cancer was 16.5% in 2014, and 16.2% in 2015. Conclusions: Dual-ISH has been used successfully implemented at Diagnostic Services Manitoba. Her-2 positive rates in breast cancer are consistent, and within the expected range. The rate of indeterminate results using Dual-ISH in our experience is low.
- Publication
Canadian Journal of Pathology, 2016, Vol 8, p42
- ISSN
1918-915X
- Publication type
Article