IHC Positive (2.1) FISH no over-amplification?????

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Lawlover2
Lawlover2 Member Posts: 5
edited June 2014 in HER2+ (Positive) Breast Cancer

Sorry if this is a duplicate. I am knew. My mother was diagnosed with well-differentiated infiltrating ductal carcinoma a few weeks ago. Surgery complete, 7mm tumor, clear margins and no lymph nodes. We were so excited! Then the path report came back . . . ER/PR+. IHC showed Her2+ (2.1)HOWEVER, FISH showed no signs of overamplification. We are so confused? The surgon said she was Her2+ but what I have read, if there is no over-amplification with FISH, she isn't Her2+. Anyone had this experience and if so, could you tell me whether this means she is or is not Her2+ and also what treatment she will likely receive. We go to the oncologist tomorrow and I am just trying to figure out what to expect to help prepare her for this. From what I have read (which is about everything I could find at this point!!), Herceptin does not work unless there is over-amplification and isnt' usually give to IHC 2+. Thanks for your help!!!

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  • daisybell
    daisybell Member Posts: 58
    edited May 2007
    Her2 IHC 2+ is not positive, it is inderminate. Besides, IHC is subjective, and different pathologists may have different interpretations. Maybe you should have another place review the IHC slides. FISH is less subjective. A well-differentiated tumor would probably not ne HER2 amplified.

    Sue
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  • Lawlover2
    Lawlover2 Member Posts: 5
    edited May 2007

    That is what I gathered from what I read but the path report states "positive for her2 overexpression by IHC in that the average staining intensity of tumor cells was greater than or equal to 2.0. However, there is no evidence of gene over-amplification since the her2/neu gene to Chromose 17 ratio is less than 2.00 by FISH." So confused, and her surgon is not good at explaining ANYTHING - he said you're Her2 positve overxpressing but not overamplified which happens . . . chemo probably . . . sending you to the med oncologist - my mom immdiately burst into tears when he walked out. I am so glad I found this forum. I have spent the past 4 weeks reading 5 books and about every website out there. I am so much more educated on breast cancer. I wish there was more I could do . . . I had no idea how many people are affected by this until this happened to my mom. Thank you for all your help!

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  • Annaanne
    Annaanne Member Posts: 190
    edited May 2007
    Hi lawlover2:
    What a loving daughter you are! You've probably already figured this out, but second and third (maybe even fourth) opinions are in order here. You may want the path redone, and oncologists are much more informed than surgeons about whether chemo is useful or not. You're right -- something about what that surgeon is saying doesn't add up. You might even want to get an opinion from a big breast center, even if you have to travel, just to give you better info. Your mom has time to research and look around.
    Good luck
    L
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  • Lawlover2
    Lawlover2 Member Posts: 5
    edited May 2007

    She is coming to St. Louis (I live here, she lives in central MO) to the St. Louis Breast Cancer Clinic, which from what I have heard and read, is very good. She refused to travel beyond that and certainly won't have treatment here. But, if I can atleast get her to speak with someone here, I will feel better. Thanks for your help!

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  • Annaanne
    Annaanne Member Posts: 190
    edited May 2007
    Sounds good. I bet this will all get resolved soon.
    Best
    A
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