PMID- 29595316
OWN - NLM
STAT- MEDLINE
DCOM- 20190701
LR  - 20190701
IS  - 1543-2165 (Electronic)
IS  - 0003-9985 (Linking)
VI  - 142
IP  - 12
DP  - 2018 Dec
TI  - Double-Equivocal HER2 Invasive Breast Carcinomas: Institutional Experience and 
      Review of Literature.
PG  - 1511-1516
LID - 10.5858/arpa.2017-0265-RA [doi]
AB  - CONTEXT.-: HER2 status is a prognostic factor and therapeutic target in invasive 
      breast carcinomas. Reflex testing using an alternate method is recommended on 
      equivocal cases via immunohistochemistry or fluorescence in situ hybridization 
      (FISH). Therapeutic dilemmas arise when both tests are equivocal. The standard 
      chromosome 17 centromere reference probe (CEP17) is in close proximity to the 
      HER2 locus and may be coamplified, leading to equivocal results. Alternate 
      chromosome 17 reference probes may aid in establishing the true HER2 status. 
      OBJECTIVE.-: To describe our institutional experience using D17S122 probe for 
      reflex FISH testing on double-equivocal invasive breast carcinomas and review the 
      literature on alternate reference probes. DATA SOURCES.-: Twenty-two patients 
      with double-equivocal invasive breast carcinomas, defined as HER2 
      immunohistochemistry score 2+ and FISH equivocal per the 2013 guidelines, were 
      reviewed. Reflex FISH was performed with alternate probe D17S122 and the HER2 
      status classified for 11 cases by using a revised HER2: D17S122 ratio. Seven of 
      11 cases (63.6%) were ultimately classified as HER2 positive, while 4 cases 
      (36.4%) remained equivocal. The 7 positive cases showed a HER2: D17S122 greater 
      than 2.0. CONCLUSIONS.-: Alternate probe D17S122 reclassified more than half of 
      our cases as HER2 positive. Alternate probes may establish true HER2 status and 
      direct proper management, as evidenced by our experience and the literature. 
      Additional investigation is needed to determine which alternate probe(s) is(are) 
      best for reflex testing. Finally, the American Society of Clinical 
      Oncology/College of American Pathologists guidelines may need to be updated to 
      reflect more specific recommendations for the utilization of appropriate probes 
      in double-equivocal HER2 cases.
FAU - Griffin, Brannan B
AU  - Griffin BB
AD  - From the Department of Pathology, Section of Breast Pathology, Northwestern 
      University, Feinberg School of Medicine, Chicago, Illinois.
FAU - Pincus, Jennifer L
AU  - Pincus JL
AD  - From the Department of Pathology, Section of Breast Pathology, Northwestern 
      University, Feinberg School of Medicine, Chicago, Illinois.
FAU - Siziopikou, Kalliopi P
AU  - Siziopikou KP
AD  - From the Department of Pathology, Section of Breast Pathology, Northwestern 
      University, Feinberg School of Medicine, Chicago, Illinois.
FAU - Blanco, Luis Z Jr
AU  - Blanco LZ Jr
AD  - From the Department of Pathology, Section of Breast Pathology, Northwestern 
      University, Feinberg School of Medicine, Chicago, Illinois.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20180329
PL  - United States
TA  - Arch Pathol Lab Med
JT  - Archives of pathology & laboratory medicine
JID - 7607091
RN  - 0 (Biomarkers, Tumor)
RN  - EC 2.7.10.1 (ERBB2 protein, human)
RN  - EC 2.7.10.1 (Receptor, ErbB-2)
SB  - IM
MH  - Biomarkers, Tumor/*genetics/metabolism
MH  - Breast Neoplasms/classification/*diagnosis/genetics/pathology
MH  - Chromosomes, Human, Pair 17/*genetics
MH  - Female
MH  - Humans
MH  - In Situ Hybridization, Fluorescence
MH  - Prognosis
MH  - Receptor, ErbB-2/*genetics/metabolism
EDAT- 2018/03/30 06:00
MHDA- 2019/07/02 06:00
CRDT- 2018/03/30 06:00
PHST- 2018/03/30 06:00 [pubmed]
PHST- 2019/07/02 06:00 [medline]
PHST- 2018/03/30 06:00 [entrez]
AID - 10.5858/arpa.2017-0265-RA [doi]
PST - ppublish
SO  - Arch Pathol Lab Med. 2018 Dec;142(12):1511-1516. doi: 10.5858/arpa.2017-0265-RA. 
      Epub 2018 Mar 29.