Confused

sflow

Finished radiation in March for IDC .8mm no nodes grade 3. I had no chemo, but lumpectomy and taking Arimidex. In reading my path report, says, "immunohistochemical stains for ER PR are positive and Her Neu 2+. No amplification fo the HER2/NEU by FISH analysis. I am assuming that means I am triple positive???
I have not been offered Herceptin by my oncologist. Should I discuss this with him? Please help.

AlaskaAngel

The more you learn, the better, but all of us have a hard time at first figuring it out.

There are 2 commonly used tests to figure out whether you are HER2 "positive" enough to benefit from treatment with drugs specifically for that kind of cancer. The IHC test is less expensive and is often used first. If you test "+++" by IHC, you are thought to benefit from the treatment for HER2 positive cancer. If you test "++", that is more "iffy", and then they will apply the FISH test as well for confirmation. It sounds like you tested ++ by IHC and then negative by FISH. (You wrote "HER neu 2+" so I'm not quite sure, but that is my guess.)

To make things a little more confusing... at a recent major conference about these things, some information was presented indicating that it is possible that some who are only "++" actually might get some benefit from drugs like Herceptin.

You may want to ask your onc what he or she thinks about that possibility.

AlaskaAngel

sflow

Report does say HER/NEU 2+. Since the FISH test said no amplification--does that mean I am positive or not?

AlaskaAngel

My impression is that you may have tested "iffy" (++) by IHC. They normally do not write the results like you have written them because it is confusing. What you have written could mean you tested "++" OR that you tested "HER2/neu positive" by IHC. Then when the FISH test was applied to verify the IHC results, the FISH was negative, which is considered to mean you tested negative.

However, there is some very, very recent info that those who are marginally positive may benefit from Herceptin. Ask your onc about this:

http://www.medscape.com/viewarticle/558918_2

(Discussion about use of Herceptin in populations previously considered Her2-.)