Comparing subjective and digital image analysis HER2/neu expression scores with conventional and modified FISH scores in breast cancer.
BACKGROUND
HER2/neu expression and fluorescence in situ hybridisation (FISH) amplification have therapeutic significance.


OBJECTIVE
To compare 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 two 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.
Skaland
I
I
Department of Pathology, Stavanger University Hospital, Stavanger, Norway.
Øvestad
I
I
Janssen
E A M
EA
Klos
J
J
Kjellevold
K H
KH
Helliesen
T
T
Baak
J P A
JP
D014408:Biomarkers, Tumor / Q000378:metabolism*; D001943:Breast Neoplasms / Q000378:metabolism*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D017404:In Situ Hybridization, Fluorescence / Q000379:methods; D011446:Prospective Studies; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000378:metabolism*; D015203:Reproducibility of Results
D014408:Biomarkers, Tumor; D018719:Erb-b2 Receptor Tyrosine Kinases