How do you tell if you are her2+ or ++ or +++

JeninMichigan

I was talking to a friend of mine and she said she was her2+++.   She said the significance of this meant that Herceptin was much more likely to control her cancer.  She is stage IV and has been NED now for over 5 years.   I will ask my onc this at my October appoitnment but wondering if it had to do with your fish anaylsis numbers?  Anyone know?

Jennifer

cbm

Hi, Jennifer; this is always confusing to me, but I think I know.  There are 2 methods--IHC (the one with all the pluses) and FISH (the one with the ratio).

IHC:  this one stains the Her2 protein on the tumor cells.  0 and 1 + is negative, 3+ means good staining of more than 30% of the tumor.  2+ is borderline, which means you have to try the FISH.

FISH: this one counts copies of the Her2 gene by marking them with genetic material.  If more than 6 copies of the Her2 gene are detected per cell OR more than 2.2 Her2 genes are counted per CEP17, tumor is Her2 positive.  (that's also the Her2/CEP17 ratio)  A tumor is negative if there are fewer than 4 copies of the Her2 gene per cell.  Borderline if betwen 4 and 6. 

I hope this helps.  I got only FISH on my path report and could not figure out all the +++ ; drove me nuts until I investigated.  Someone more technically competent may be able to explain it better!

Cathy

orange1

I read an abstract that showed that for any way Her2 positivitey is measured (IHC or FISH), Herceptin helps.  It even reduces recurrences significantly even if the patient was only 1+ or 2+ on IHC.  Based on this information, the authors were arguing that eligability for Herceptin should be expanded. I am travelling now, but will be happy to find it and post specifics when I am back home and can find it (I have a print version).  PM me if you would like it.