no her2 results on biopsy report

My Estrogen, Progesterone and HER2 results took 3 days longer than the pathology report.

My original path report contained only ER/PR characteristics. In many cases, the HER2 is sent out, so it takes longer. When that result comes back in, they send an addendum path report with all fields completed. Mine took a bit longer as the first result was equivocal, so they had to do FISH for a final result. I think it was 10 or so days before I had my final path report.

good point ElaineTherese, not everyone with DCIS is tested for HER2. Mine was, as I was young (38) and they anticipated something worse might be found, so they went ahead and ordered it.

Not necessarily. My understanding is that there are 2 main ways to look at HER2, IHC and FISH. Each lab has their own protocol for which test they use as the first.

"The two main ways to test HER2/neu status in tumors are:

• Immunohistochemistry (IHC)—measures the amount of HER2 protein present and detects over-expression of the protein
• Fluorescent in situ hybridization (FISH)—looks at the genetic level for an increase in the number of copies of the gene present, known as amplification

Both IHC and FISH are acceptable testing methods, according to the latest ASCO/CAP guidelines, but if one test is indeterminate or negative, then the other should be done as a follow-up test." (from labtestsonline.org)

So the second test is used as a confirmation if the first is equivocal. That should be stated in your path report, so if it only indicates HER2 FISH (without stating HER2 IHC - equivocal), then they only did the FISH and the result was clear using that as the first (and only) test.

My understanding is that they don't know reliably what HER2 means in DCIS. There have been good studies with mixed results (some finding HER2 is an indicator of more aggression and some finding the reverse) so they won't start routinely testing for HER2 in DCIS until they know exactly what it's implications are for treatment.

This study indicated that HER2 over-amplification was more likely associated with invasive disease. But

this study got my attention: https://www.ncbi.nlm.nih.gov/pubmed/23208673 which postulated that "results suggest that quick tumor progression might be the main feature of the triple-negative breast tumors, leading to seldom triple-negative DCIS at the time of breast cancer diagnosis".