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Human epidermal growth factor receptor 2 testing in invasive breast cancer: should histological grade, type and oestrogen receptor status influence the decision to repeat testing?

Rakha, Emad A; Pigera, Marian; Shin, Sandra J; D'Alfonso, Timothy; Ellis, Ian O; Lee, Andrew H S

Authors

EMAD RAKHA Emad.Rakha@nottingham.ac.uk
Professor of Breast Cancer Pathology

Marian Pigera

Sandra J Shin

Timothy D'Alfonso

Andrew H S Lee



Abstract

Aims

The recent American Society of Clinical Oncology/College of American Pathologists guidelines for human epidermal growth factor receptor 2 (HER2) testing in breast cancer recommend repeat testing based on tumour grade, tumour type, and hormone receptor status. The aim of this study was to test the value of these criteria.

Methods and results

HER2 status was concordant in the core biopsies and excision specimens in 392 of 400 invasive carcinomas. The major reasons for discordance were amplification around the cut?off for positivity and tumour heterogeneity. Of 116 grade 3 carcinomas that were HER2?negative in the core biopsy, four were HER2?positive in the excision specimen. Three of these four either showed borderline negative amplification in the core biopsy or were heterogeneous. None of the 55 grade 1 carcinomas were HER2?positive. Review of repeat testing of HER2 in routine practice suggested that it may also be of value for multifocal tumours and if recommended by the person assessing the in?situ hybridization.

Conclusions

Mandatory repeat HER2 testing of grade 3 HER2?negative carcinomas is not appropriate. This is particularly true if repeat testing is performed after borderline negative amplification in the core biopsy or in HER2?negative heterogeneous carcinomas.

Citation

Rakha, E. A., Pigera, M., Shin, S. J., D'Alfonso, T., Ellis, I. O., & Lee, A. H. S. (2016). Human epidermal growth factor receptor 2 testing in invasive breast cancer: should histological grade, type and oestrogen receptor status influence the decision to repeat testing?. Histopathology, 69(1), 20-24. doi:10.1111/his.12900

Journal Article Type Article
Acceptance Date Oct 31, 2015
Online Publication Date Jan 7, 2016
Publication Date 2016-07
Deposit Date Nov 21, 2018
Journal Histopathology
Print ISSN 0309-0167
Publisher Wiley
Peer Reviewed Peer Reviewed
Volume 69
Issue 1
Pages 20-24
DOI https://doi.org/10.1111/his.12900
Public URL https://nottingham-repository.worktribe.com/output/1293056
Publisher URL https://onlinelibrary.wiley.com/doi/full/10.1111/his.12900