title: Comparing subjective and digital image analysis HER2/neu expression scores with conventional and modified FISH scores in breast cancer.
abstract: 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.
authors.affiliation: Department of Pathology, Stavanger University Hospital, Stavanger, Norway.
authors.forename: I
authors.initials: I
authors.lastname: Skaland
authors.forename: I
authors.initials: I
authors.lastname: Øvestad
authors.forename: E A M
authors.initials: EA
authors.lastname: Janssen
authors.forename: J
authors.initials: J
authors.lastname: Klos
authors.forename: K H
authors.initials: KH
authors.lastname: Kjellevold
authors.forename: T
authors.initials: T
authors.lastname: Helliesen
authors.forename: J P A
authors.initials: JP
authors.lastname: Baak
mesh_terms: 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
chemical_list: D014408:Biomarkers, Tumor; D018719:Erb-b2 Receptor Tyrosine Kinases