Should a borderline negative HER2 result in a core biopsy of invasive carcinoma of the breast have HER2 assessment repeated in the excision specimen?

Autor:	Lee AHS; Histopathology Department, Nottingham University Hospitals NHS Trust, Nottingham, UK andrew.lee@nuh.nhs.uk., Hodi Z; Histopathology Department, Nottingham University Hospitals NHS Trust, Nottingham, UK.; Source BioScience plc, Nottingham, UK., Abbas A; Histopathology Department, Nottingham University Hospitals NHS Trust, Nottingham, UK., Wencyk P; Source BioScience plc, Nottingham, UK., Ellis IO; Histopathology Department, Nottingham University Hospitals NHS Trust, Nottingham, UK.; Source BioScience plc, Nottingham, UK., Rakha E; Histopathology Department, Nottingham University Hospitals NHS Trust, Nottingham, UK.
Jazyk:	angličtina
Zdroj:	Journal of clinical pathology [J Clin Pathol] 2024 Oct 20; Vol. 77 (11), pp. 726-729. Date of Electronic Publication: 2024 Oct 20.
DOI:	10.1136/jcp-2023-209091
Abstrakt:	Aim: The 2015 UK guidelines for HER2 assessment in breast cancer recommended repeat assessment if the core biopsy was scored as 2+ on HER2 immunohistochemistry (IHC) with borderline negative in situ hybridisation (ratio of number of HER2 to chromosome 17 centromere copies of 1.8-1.99). This case series aimed to assess the value of such repeat assessment in the surgical specimen, in particular the proportion that were HER2 positive. Methods: Details of biopsies with 2+ IHC and borderline negative in situ hybridisation were extracted from a database. The results of repeat HER2 testing in the surgical specimen for this cohort study were then obtained. Results: 112 patients with no preoperative treatment had repeat assessment: 4 were 3+ and 16 were 2+ amplified. Of 14 with preoperative chemotherapy, 1 was 3+ and 4 were 2+ amplified. All the 2+ amplified carcinomas had a HER2 to chromosome 17 ratio less than 4, in 50% the ratio was between 2.0 and 2.2, and in 50% the HER2 copy number was less than 4. Conclusions: Repeat assessment yielded 4% 3+ results and 14% 2+ amplified carcinomas but with low level amplification. These results suggest that retesting of borderline negative HER2 cases should be optional and no longer mandatory. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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