Document Detail

Reliability of human epidermal growth factor receptor 2 immunohistochemistry in breast core needle biopsies.
MedLine Citation:
PMID:  20498397     Owner:  NLM     Status:  MEDLINE    
PURPOSE: Core needle biopsies (CNBs) are widely used to determine human epidermal growth factor receptor 2 (HER2) status in breast cancer. Recent publications reported up to 20% false-positive results on CNBs if immunohistochemistry (IHC) is compared with fluorescent in situ hybridization (FISH). To clarify, if confirmation of IHC positivity by FISH is generally required, we analyzed the reliability of IHC positivity on CNBs versus surgical specimens in a multi-institutional study. PATIENTS AND METHODS: Five pathologic laboratories contributed to this study by performing IHC on 500 CNBs and the corresponding surgical specimens overall. If IHC revealed score 2+ or 3+, HER2 status was confirmed by FISH in a central laboratory. We compared evaluation according to US Food and Drug Administration-approved scoring criteria and recently published American Society of Clinical Oncology (ASCO)-College of American Pathologists (CAP) guidelines. RESULTS: CNBs scored 3+ revealed five false-positive results if scoring followed the US Food and Drug Administration criteria (five of 40; 12.5%) and two false-positives in terms of the ASCO-CAP criteria (two of 33; 6.1%). IHC was false negative in one CNB only. By contrast, IHC on surgical specimens revealed five false-negative results, but only one false-positive result (one of 35; 2.9%) if scored following US Food and Drug Administration-approved criteria. With the aid of the ASCO-CAP criteria, false-positive IHC results were obtained in only one of the five participating institutions. CONCLUSION: IHC 3+ scores on CNBs proved to be reliable in four of the five participating institutions if scoring followed the ASCO-CAP criteria. Therefore, accurate determination of HER2 status in breast cancer is possible on CNB using the common strategy to screen all cases by IHC and retest only 2+ scores by FISH. Prerequisites are quality assurance and the application of the new ASCO-CAP criteria.
Annette Lebeau; Andreas Turzynski; Susanne Braun; Wera Behrhof; Barbara Fleige; Wolfgang D Schmitt; Tobias J Grob; Lia Burkhardt; Dieter Hölzel; Christian Jackisch; Christoph Thomssen; Volkmar Müller; Michael Untch
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Publication Detail:
Type:  Evaluation Studies; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't     Date:  2010-05-24
Journal Detail:
Title:  Journal of clinical oncology : official journal of the American Society of Clinical Oncology     Volume:  28     ISSN:  1527-7755     ISO Abbreviation:  J. Clin. Oncol.     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-07-09     Completed Date:  2010-07-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8309333     Medline TA:  J Clin Oncol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  3264-70     Citation Subset:  IM    
Department of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
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MeSH Terms
Biopsy, Needle
Breast Neoplasms / metabolism*,  pathology
False Negative Reactions
False Positive Reactions
Guidelines as Topic
In Situ Hybridization
Receptor, erbB-2 / metabolism*
Reproducibility of Results
Reg. No./Substance:
EC, erbB-2

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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