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HER-2 and Fluorescent In Situ Hybridization to Evaluate Breast Cancer—Reply
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In Reply: Dr Tanvetyanon is concerned that some 3+ IHC test results would be found to be false-positives if evaluated with FISH. It is not clear whether this is true. First, the mechanism underlying protein overexpression is not limited to gene amplification. In 2 large studies (561 and 690 invasive breast cancers, respectively),1-2 chromosome 17 polysomy was found in almost half of the tumors with 3+ IHC with negative FISH results, suggesting an increased absolute number of chromosome 17 alleles in these cases led to HER-2 protein overexpression. Second, some studies indicate a response to trastuzumab in patients with 3+ IHC with negative FISH results. In the study by Vogel et al,3 the group of patients with 3+ IHC with negative FISH results composed of 30 patients, 3 of whom (10%) showed response to treatment. Furthermore, in the reanalysis by the Food and Drug Administration of company data to validate . . . [Full Text of this Article]
Hadi Yaziji, MD
yaziji@phenopath.com
Department of Pathology
Baptist Hospital of Miami
Miami, Fla
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