Predicting the HER2 status of breast cancer from basic histopathology data: an analysis of 1500 breast cancers as part of the HER2000 International Study

Bilous, M., Ades, C., Armes, J., Bishop, J., Brown, R., Cooke, B., Cummings, M., Farshid, G., Field, A., Morey, A., McKenzie, P., Raymond, W., Robbins, P. and Tan, L. (2003) Predicting the HER2 status of breast cancer from basic histopathology data: an analysis of 1500 breast cancers as part of the HER2000 International Study. Breast, 12 2: 92-98. doi:10.1016/S0960-9776(02)00273-4


Author Bilous, M.
Ades, C.
Armes, J.
Bishop, J.
Brown, R.
Cooke, B.
Cummings, M.
Farshid, G.
Field, A.
Morey, A.
McKenzie, P.
Raymond, W.
Robbins, P.
Tan, L.
Title Predicting the HER2 status of breast cancer from basic histopathology data: an analysis of 1500 breast cancers as part of the HER2000 International Study
Journal name Breast   Check publisher's open access policy
ISSN 0960-9776
Publication date 2003-04
Sub-type Article (original research)
DOI 10.1016/S0960-9776(02)00273-4
Volume 12
Issue 2
Start page 92
End page 98
Total pages 7
Editor H.-J. Senn
Place of publication Edinburgh, U.K.
Publisher Elsevier Science Ltd.
Collection year 2003
Language eng
Subject C1
321020 Pathology
730108 Cancer and related disorders
Abstract The tests that are currently available for the measurement of overexpression of the human epidermal growth factor-2 (HER2) in breast cancer have shown considerable problems in accuracy and interlaboratory reproducibility. Although these problems are partly alleviated by the use of validated, standardised 'kits', there may be considerable cost involved in their use. Prior to testing it may therefore be an advantage to be able to predict from basic pathology data whether a cancer is likely to overexpress HER2. In this study, we have correlated pathology features of cancers with the frequency of HER2 overexpression assessed by immunohistochemistry (IHC) using HercepTest (Dako). In addition, fluorescence in situ hybridisation (FISH) has been used to re-test the equivocal cancers and interobserver variation in assessing HER2 overexpression has been examined by a slide circulation scheme. Of the 1536 cancers, 1144 (74.5%) did not overexpress HER2. Unequivocal overexpression (3+ by IHC) was seen in 186 cancers (12%) and an equivocal result (2+ by IHC) was seen in 206 cancers (13%). Of the 156 IHC 3+ cancers for which complete data was available, 149 (95.5%) were ductal NST and 152 (97%) were histological grade 2 or 3. Only 1 of 124 infiltrating lobular carcinomas (0.8%) showed HER2 overexpression. None of the 49 'special types' of carcinoma showed HER2 overexpression. Re-testing by FISH of a proportion of the IHC 2+ cancers showed that only 25 (23%) of those assessable exhibited HER2 gene amplification, but 46 of the 47 IHC 3+ cancers (98%) were confirmed as showing gene amplification. Circulating slides for the assessment of HER2 score showed a moderate level of agreement between pathologists (kappa 0.4). As a result of this study we would advocate consideration of a triage approach to HER-2 testing. Infiltrating lobular and special types of carcinoma may not need to be routinely tested at presentation nor may grade 1 NST carcinomas in which only 1.4% have been shown to overexpress HER2. Testing of these carcinomas may be performed when HER2 status is required to assist in therapeutic or other clinical/prognostic decision-making. The highest yield of HER2 overexpressing carcinomas is seen in the grade 3 NST subgroup in which 24% are positive by IHC. (C) 2003 Elsevier Science Ltd. All rights reserved.
Keyword Oncology
Obstetrics & Gynecology
In-situ Hybridization
Her-2/neu Oncogene Amplification
Archival Tissue Samples
Immunohistochemistry
Expression
Overexpression
Carcinoma
Disease
Q-Index Code C1

Document type: Journal Article
Sub-type: Article (original research)
Collections: Excellence in Research Australia (ERA) - Collection
2004 Higher Education Research Data Collection
School of Medicine Publications
 
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