HER 3+++

ginasmimi

My original biopsy showed I was HER+++Fish was negative and onctotype test was HER Neg.

Going for second opinion oncologist within the next couple of weeks. Wondering if anyone else had test results like this? If one test shows HER+ and two test show HER - what am I?  Oncotype claims their testing is the latest and the best.

mattscot

My original biopsy was HER- my pathology was ICH borderline 2+, 2.3 on FISH  which is considered positive, (borderline) and then to my surprise and my doctor's-- HER negative on the oncotype (and a lowish score 16 because of HER2 negative )  the Oncotype uses a different test based RNA anaylisis -- and I think will eventually trump the FISH.  I was told that the FISH is now what is relied on..

Good chance they will probably determine you to be HER-.. By the way did they do an ICH on your pathology after surgery or just on the biopsy samples?? Anyway let me know how your second opinion goes.   

I am still going with Herceptin (and chemo -- due to possible Her+ and tumorsize).  

Below is a cite to an article regardy polysomy 17 (extra copies of chromosome 17)in breast cancer that has caused these conflicting HER2 results...

Vanden Bempt I, Van Loo P, Drijkoningen M, et al: Polysomy 17 in breast cancer: Clinicopathologic significance and impact on HER-2 testing. J Clin Oncol doi:10.1200/JCO.2007.13.4296 [epub ahead of print on September 15, 2008][Abstract/Free Full Text]

ginasmimi

Thanks for the reply.  Could not open the article but did a search for Polysomy 17.  Really do not understand any of it.  However, my path reports from surgery show IHC3+ . FISH neu Her signal cep17/robe signal 1.3 non amplified, oncotype score 22, Her neg.  I"ll let you know what the second opinion is.

mattscot

ginasmimi,

whats damn interesting is that the standard protocol I was advised that if your ICH was 3+ then they dont bother with the FISH... expensive test blah blah-- so you would have been labled HER2+.  Supposedly I had a FISH because my ICH was +2.  what a flip flop.... it appears right now FISH is considered to trump ICH.   As I said, I think the Oncotype will be considered to trump both tests -- but it is too new right now. By the way, one of my oncologists (the one I did not go with) was very opposed to the Oncotype test because I had the Her2+ status.  They knew I was going to have a high score and that I was going to need chemo-- so why bother. they were wrong.....Oncotype dx has alot of value in the lower HER2+ cases and should definately be done. 

The basic issue with Polysomy 17 is that the reason for the borderline and inconsistant resultsin HER2 testing is that in a number of cases  have duplicate chromosome 17 which is the same gene that  HER2 appears on and that these cases are a new subtype. The article goes on to state that those with polysomy 17 are HER2 -'s  and would not benefit from Herceptin... but further studies are being done.  

Regarding the article copy the cite and then put in your browser (was not a link) Please let me know how it goes... when I see my doctor I will discuss the polysomy 17 issue.