HER2 status

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nmi
nmi Member Posts: 180
edited June 2014 in HER2+ (Positive) Breast Cancer

I recently got my pathology report from mastectomy and have been trying to decipher everything.  I am ER +, PR+, and in the middle on my HER2. I had 2 tumors, one had onco score of 4, the other 16.  I am trying the figure this HER2. Have not seen oncologist yet, but trying to know what to expect.Thanks for any info anyone can give.

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  • azsunn
    azsunn Member Posts: 201
    edited December 2009

    I'm answering to give your thread a bump up.

    I'm not positive on this, but it was my understanding (and may well be wrong) that the Oncotype test was not used on HER2+ cancers.  This was my experience Nov. 2007, things may have changed by now.

    Good luck to you! 

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  • Artemis
    Artemis Member Posts: 759
    edited December 2009
    nmi ~ I was HER2 neutral on the initial path report.  The later FISH test put me at 2.2 which is still considered neutral, but I'm on Herceptin anyway.  I had no oncotype test, but I *think* that's because I had chemo before surgery due to my tumor's being grade 3.
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  • nmi
    nmi Member Posts: 180
    edited December 2009

    Thanks for responding!

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  • DancingDeb81
    DancingDeb81 Member Posts: 11
    edited December 2009

    I too can't understand my status.  Mine says HER2 oncogene product: 1+ (negative) 

    Pathology stage:  T1c, N1, MX   - Help 

    Infiltrating carcinoma with mixed lobular and ductal features, grade 2/3 No definite in-situ component seen? 

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  • KristyAnn
    KristyAnn Member Posts: 793
    edited December 2009

    My center doesnt do the oncotype on HER2+ patients because the numbers are always high on recurrence based on the HER2+ - of course, Herceptin changed the treatment protocols but my onc never uses oncotype on Her2+

    Kristy

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  • nmi
    nmi Member Posts: 180
    edited December 2009

    DancingDeb81, I try to help. I don't know why they don't write these reports in English so we can understand them.  This is what I have learn from looking up things from my report: T1c is a stage 1 tumor (the c indicates maybe close to a 2 by not quite). N1= some lymph node involvement. MX=unable to determine if it has spread.  I believe the MX is on all invasive or infiltrating cancers because they can't tell for sure if any cell have gotten loose.  My report has MX also, but all my test indicate a very good prognosis.  I hope this helps you and wish you the best.

    I forgot, the HER2 +1 neg- is good( what is your ER and PR ?)

    nancy

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  • Brenda_R
    Brenda_R Member Posts: 509
    edited December 2009

    Her2 +1 is negative, +2 is neutral, +3 is positive. It's the degree of staining on the test.

    If I recall, they are now recommending Herceptin for the +2's, and I'd definately take it.

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  • DancingDeb81
    DancingDeb81 Member Posts: 11
    edited December 2009

    Thanks Nancy and Brenda

    You have explained it for me!

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  • orange1
    orange1 Member Posts: 930
    edited December 2009

    0 and 1+ are considered negative

    +2 is not neutral;  it is equivocal (uncertain).  +2 should always be sent out for FISH testing which typically provides results that are easier to interpret than IHC testing

    +3 is clearly positive

    Because FISH testing is considerably more expensive than IHC testing most labs perform IHC testing on all tumors and then test FISH only on tumors that are +2 on IHC.  FISH testing may take a couple weeks to complete because tumor samples have to be sent to a central lab.

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  • swimangel72
    swimangel72 Member Posts: 1,989
    edited December 2009

    Excellent response Orange1 - for more info on the FISH test, check out this link:

    http://www.breastcancer.org/symptoms/testing/types/fish.jsp 

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  • Brenda_R
    Brenda_R Member Posts: 509
    edited December 2009

    Uncertain or neutral, it means the same to me. It's borderline and needs to be re-tested.

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  • nmi
    nmi Member Posts: 180
    edited December 2009

    Thanks for the additional information.  It does seem that as I get more info and start to understand some of this stuff, it also gets more confusing.  Is it just me?? OK, next question, My HER2 FISH:  Nonamplified.  I believe this means I am negative for her2, right.  But, since I have mulitfocal (I had 2 tumors, do both sites have to be tested for HER2, like they did my Onco scores?  Would not each tumor have a different gene make-up? I see oncologist on Thursday, these some questions I have. Maybe I am making a big deal out of this when I shouldn't, and just be grateful the I am HER2 -

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  • nmi
    nmi Member Posts: 180
    edited December 2009

    Here's the latest! I have two tumors, but pathologist only tested one for er, pr and her2.  When surgeon sent off for onco testing one tumor came back her2 neg and the other her2 neutral.  The path report only had one result not two. anyway, the oncologist has requested the other tumor be tested for er, pr and her2. could make a big difference!  No wonder this was so confusing to me. Make sure you have some understanding of you path reports, my surgeon did not even catch this mistake. 

    What 's your opinion on breast MRI's, my surgeon thinks they give too many false positives so I had a PET scan.  But the pet scan did not even pick up any of my cancers, Now I am concerned about my other breast.  I guess it's worry we all have after this, debating if I should go ahead to do MRI at some point-any feeling on this?????

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  • blondie45
    blondie45 Member Posts: 580
    edited February 2010

    nmi - although I never had a PET scan, my tumor was not found on a mammogram but showed up fine on an MRI and they could also tell I had positive lymph nodes on the MRI. I will be fighting for MRI for the rest of my life on my remaining breast no matter what I have to do to get one.

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  • suzieq60
    suzieq60 Member Posts: 6,059
    edited February 2010

    I was lucky mine was found on a mammogram at such an early stage but I am freaked out about the other breast too and am going to insist on an MRI. I'm changing surgeons so will meet the new one tomorrow. I had lobular cancer which is sneaky and doesn't always show up on mammos, so it makes sense to check it out further.

    Sue

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