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J Clin Pathol doi:10.1136/jcp.2007.046763

Comparing subjective and digital image analysis HER2/neu expression scores with conventional and modified FISH scores in breast cancer

  1. Ivar skaland (skiv{at}sus.no)
  1. Stavanger University Hospital, Norway
    1. Irene Oevestad (ovir{at}sus.no)
    1. Stavanger University Hospital, Norway
      1. Emiel A.M Janssen (jaem{at}sus.no)
      1. Stavanger University Hospital, Norway
        1. Jan Klos (klja{at}sus.no)
        1. Stavanger University Hospital, Norway
          1. Kjell H Kjellevold (kjkh{at}sus.no)
          1. Stavanger University Hospital, Norway
            1. Tove Helliesen (grth{at}sus.no)
            1. Stavanger University Hospital, Norway
              1. Jan P. A. Baak (jpabaak{at}yahoo.com)
              1. Stavanger University Hospital and Gade Institute University of Bergen, Norway
                • Published Online First 5 April 2007

                Abstract

                Aims: HER2/neu expression and fluorescence in situ hybridization (FISH) amplification have therapeutic significance. We compared subjective HER2/neu expression scores with digital image analysis (DIA) and conventional and modified FISH scores in breast cancer.

                Methods: Sixty HercepTest-immunostained breast carcinomas, prospectively scored as consensus 2+ and 3+ (DAKO protocol) by 2 observers, were analysed with DIA and conventional (Vysis) and modified FISH scoring protocols.

                Results: With consensus scoring, 23 (38%) of the 60 cases were 2+ and 37 (62%) were 3+. Agreement with DIA scores was 100%. With conventional FISH scoring, 4 of the 3+ cases did not show amplification, but all of those negative cases had high HER2/neu copy numbers. With the modified FISH scoring protocol, all HercepTest immunohistochemical 3+ cases were amplified. Of the 2+ cases, 3 were amplified with the modified FISH protocol and 4 with the conventional FISH protocol.

                Conclusions: Modified FISH scores were better correlated with HercepTest 3+ consensus and DIA scores than were conventional FISH scores. HER2/neu DIA scoring is a cost-effective supplementary tool in surgical pathology.

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