skip to the content

Testing algorithm

 

All breast cancer patients should be tested accurately for HER2 status at primary diagnosis, or at the time of disease recurrence, so that optimal patient management can be provided.1-4

Only patients with HER2-positive status should be considered for Herceptin therapy.5

IHC can be used as the first-line testing method, allowing identification of patients with HER2 IHC 3 tumours who may benefit from Herceptin therapy.
 

  • Patients with IHC 0/1 tumours should not be treated with Herceptin.
     
  • Patients with IHC 2 tumour samples should be retested using ISH, to ensure that all patients who may benefit from Herceptin are identified.
     

First-line testing can also be performed using an ISH technique.

For equivocal cases regardless of the initial method applied it is recommended to retest with another method.

 
 


 

Figure 5.3 HER2-testing algorithm5 (reprinted by permission from Macmillan Publishers Ltd: copyright 2006)

 
 
 
References

 

  1. Dowsett M et al. J Clin Pathol 2007; 60: 685-689.
  2. Goldhirsch A et al. Ann Oncol 2006; 17: 1772-1776.
  3. Hanna W et al. Curr Oncol 2007; 14: 149-153.
  4. Wolff AC et al. J Clin Oncol 2007; 25: 118-145.
  5. Hanna WM, Kwok K. Mod Pathol 2006; 19: 481-487.