Conflicting HER2 status - help

Options
samdobbs
samdobbs Member Posts: 40
edited June 2014 in HER2+ (Positive) Breast Cancer
I'm posting for my wife Liddy stats below.

We just received results from OnctotypeDX showing
Her2 Negative! Overall RS 24

Previously FISH was +ive (2.8) after equivocal IHC

Anyone encountered this situation? Any pointers to
reliability/accuracy of FISH vs. Oncotype?

Thanks in advance

Sam

--
49 years old, premenopausal, IDC and DCIS present, no family history
12/28/10 Excised tumor 1.5x1.0x0.9 cm, clean margins
Grade: Histologic 2, Nuclear 2, Mitotic 1, Overall grade 1(2+2+1=5)
Sentinel Nodes: 0/3,
ER+ (60%), PR+ (86%)
HER2+ Eqv by IHC, Positive by FISH (2.8), Negative by Oncotye (10.0)
Ki-67 = 3+ intensity, 17% of cells
Overall oncotype recurrence score 24
· Share on FacebookShare on Twitter

Comments

  • lovetosail
    lovetosail Member Posts: 544
    edited January 2011

    Hi- usually FISH is considered a gold standard.  I had a somewhat similar result, HER2- on IHC and then positive on FISH.  Then, after my mx and complete examination of the tumor, it was found that some parts of it were HER2+ and some were HER2-.  It's possible that your wife's tumor may have both components, in which case she'd still want Herceptin!

    · Share on FacebookShare on Twitter
  • lago
    lago Member Posts: 17,186
    edited January 2011

    It the change from the biopsy to surgery sample? Sometimes they can only sample part of the tumor in a biopsy. In this case I'm thinking that it might be possible that the DCIS was HER2+ and the IDC is HER2-

    What did your onc say.

    · Share on FacebookShare on Twitter
  • cloverclover111
    cloverclover111 Member Posts: 3
    edited February 2011

    I, too had conflicting status. one biopsy showed her2 negative and one slightly positive. Together with my oncologist we decided to take Herceptin. The more recent studies were showing that even a very slight positive test could benefit from herceptin. Side effects were very mild. I took it for one year. 

    · Share on FacebookShare on Twitter
  • samdobbs
    samdobbs Member Posts: 40
    edited February 2011

    Thanks, Iago and cloverlover11 for your responses. The conflicting tests were from the same biopsy sample. With our onc's encouragement, we had the fish re-done at 2 other different places. Sad to say, they came back all positive so there is compelling evidence that Liddy is Her2+. She starts chemo and Herceptin next week. Now looking into cold cap to help prevent or reduce hair loss. Again, thanks very much for all your support and help.

    Sam

    · Share on FacebookShare on Twitter

Categories