Rapid screening of tissue microarrays for Her-2 fluorescence in situ hybridization testing is an accurate, efficient and economic method of providing an entirely in situ hybridization-based Her-2 testing service.
OBJECTIVE
Fluorescence in situ hybridization (FISH) testing is the 'gold standard' method for Her-2 status assessment in breast cancer patients, yet is only employed in about 30% of tests carried out because of cost and labour considerations. We have previously described tissue microarray (TMA)-based testing to eliminate cost constraints, and now describe a rapid screening approach to reduce time spent testing.


RESULTS
We examined 88 cases of invasive breast cancer on TMAs comparing formal FISH scoring with a rapid screening technique. Each core was screened by two observers and results recorded as positive, equivocal or negative. Each approach was timed. Data were analysed by comparing the rapid screening results with formal counts. Using rapid screening, two-thirds of negative and half the positive cases could be eliminated with 100% accuracy. It took 2 min per observer per case to rapid screen six TMA cores at x100 magnification. The remaining cases required formal counting, which took no longer than with whole-section techniques.


CONCLUSIONS
Rapid screening of TMAs for routine Her-2 FISH testing is safe, economical and time efficient. The technique ensures that all patients receive 'gold standard' testing.
Faratian
Dana
D
Department of Pathology, NHS Lothian and Edinburgh Breakthrough Research Unit, Western General Hospital, Edinburgh, UK.
Graham
Ashley
A
Rae
Frances
F
Thomas
Jeremy
J
D001943:Breast Neoplasms / Q000235:genetics* / Q000378:metabolism*; D005260:Female; D018734:Genes, erbB-2; D006801:Humans; D007150:Immunohistochemistry; D017404:In Situ Hybridization, Fluorescence / Q000191:economics / Q000379:methods* / Q000706:statistics & numerical data; D011237:Predictive Value of Tests; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000378:metabolism*; D013997:Time Factors; D046888:Tissue Array Analysis / Q000191:economics / Q000379:methods* / Q000706:statistics & numerical data
D018719:Erb-b2 Receptor Tyrosine Kinases; C508053:ERBB2 protein, human