Seeming discrepancy in HER2 results

Frizzylee

I was diagnosed with bc in my right breat on Jan 8, 2016. I am still feeling overwhelmed with all of it. Had a lumpectomy on January 5, 2016, brachytherapy radiation from January 18-22, 2016. Now I face chemotherapy. The tumor was small, its longest linear measurement was 4 mm. Stage 1, Grade 2.

My question is about the HER2 diagnosis. I have a pathology report from the lumpectomy (sorry, I don't see another more technical name for it.) It states: HER2: 2+ I also have a report from the OncoType DX test that states: HER2 score = 8.9 Negative. Doesn't this sound contradictory?

There is a factor in this that worries me. There was a problem with the genomic company that did the testing. My specimen was supposedly sent in January 8, 2016. By January 29 the genomic company still had no results nor could they say what happened. On Feb 3 my medical oncologist's office actually had me talk on the phone with the West Area Manager of the genomic testing company. He couldn't say where, in the process, my specimen was at that time. Then, magically, it was done February 9. Right now I am supposed to be making a decision about chemotherapy + Herceptin (I don't know all the details about that yet) based on these test results. My overall score on the OncoType DX test is 32, right on the borderline. I don't want to do chemo if it may not be warranted

Any thoughts, anyone? I sure could use some help here since the decision is mine.

Frizzylee

NancyHB

Frizzylee, so sorry you find yourself here. It's very easy to feel overwhelmed during this time of diagnosis and testing and determination, until a treatment plan is in place. It's like a crash course in cancer (definitely a class no one wants to take) and there's an incredible amount of information to absorb, and so many decisions to make.

My first time around my Her2 result was the same as yours - 2+. My oncologist indicated this was considered equivocal (an unknown or middle ground where they couldn't determine if it was positive or negative). My tumor was sent off for further FISH testing, and ultimately determined to be negative. My Oncotype score was 42, and my Her2 result was somewhere in the 9's, which in my mind confirmed the FISH testing. In the end my dx was Her2-.

I'm surprised your oncologist hasn't sent your tumor off for additional testing to determine your true Her2 status, but additionally I'm surprised they are recommending chemo for a 4mm invasive cancer. The NCCN guidelines call for chemo for tumors 5mm or greater, at which time the correct Her2 status would be imperative.

Since your tumor is so small, and you don't want to do chemo, perhaps a second opinion is in order? I'd really want more information on the Her2 status, too, if I was you, just so you have all the information you need to make a truly informed decision.

Good luck and let us know what you decide.

SummerAngel

I just want to second what Nancy said about the Her2 status. My left-side tumor was 2+ with IHC, and when the Oncotype score came back for it, the Her2 result was 9.9: Negative. I had a FISH test as well to confirm the negative result.