Interpretation of HER-2 FISH Results

From:Richard Cartun

The topic of "who should interpret HER-2 FISH results" has recently been
discussed on Histonet.

I just finished looking at a case of breast CA where the invasive
mammary duct CA was negative for HER-2/neu protein overexpression, but
the ductal carcinoma in-situ (DCIS) was 3+ positive.  It was a very
impressive specimen; the HER-2 positive DCIS surrounded the small focus
of HER-2 negative invasive tumor.  As you may already know,
determination of ER/PR/HER-2 status should be performed on invasive
tumor; not carcinoma in-situ.  I don't have a problem with non-MD's
doing the interpretation of the FISH results (keep in mind that I am a
Ph.D.), but whoever does the interpretation must know which cells to
evaluate.  By all means, if there are questions regarding the
interpretation of the FISH slides, go to the pathologist who signed-out
the case and ask them to identify the tumor for evaluation.   I
requested FISH on this specimen for HER-2/neu gene amplification for
academic purposes.  Let's see if the correct tumor cells are evaluated!

R. Cartun

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