title: High agreement between whole slide imaging and optical microscopy for assessment of HER2 expression in breast cancer: whole slide imaging for the assessment of HER2 expression.
abstract: Whole slide imaging (WSI) technology has been used for training, teaching, researching, and remote consultation. Few studies compared HER2 expression using optical microscopy (OM) and WSI evaluations in breast carcinomas. However, no consensus has been achieved comparing both assessments.
  
  
  METHODS
  Sections from tissue microarray containing 200 preselected invasive breast carcinomas were submitted to immunohistochemistry applying three anti-HER2 antibodies (HercepTest™, CB11, SP3) and in situ hybridization (DDISH). Slides were evaluated using OM and WSI (Pannoramic MIDI and Viewer, 3DHISTECH). Sensitivity and specificity were calculated comparing the anti-HER2 antibodies and DDISH.
  
  
  RESULTS
  WSI and OM HER2 evaluations agreement was considered good (SP3, k=0.80) to very good (CB11 and HercepTest™, k=0.81). WSI evaluation led to higher sensitivity (ranging from 100 of SP3 and HercepTest™ to 97 of CB11) and lower specificity (ranging from 86.4 of SP3 to 89.4 of HercepTest™) compared to OM evaluation (sensitivity ranged from 92.1 of CB11 to 98 of SP3 and specificity ranged from 95.2 of SP3 and HercepTest™ to 97.1 of CB11 and SP3).
  
  
  CONCLUSIONS
  High agreement was achieved between WSI and OM evaluations. All three antibodies were highly sensitive and specific using both evaluations. WSI can be considered a useful tool for HER2 immunohistochemical assessment.
authors.affiliation: Department of Anatomic Pathology, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil. Electronic address: cristianabnunes@gmail.com.
authors.forename: Cristiana
authors.initials: C
authors.lastname: Nunes
authors.affiliation: Department of Anatomic Pathology, AC Camargo Cancer Center, São Paulo, Brazil.
authors.forename: Rafael
authors.initials: R
authors.lastname: Rocha
authors.affiliation: Department of Anatomic Pathology, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil.
authors.forename: Marcelo
authors.initials: M
authors.lastname: Buzelin
authors.affiliation: Department of Anatomic Pathology, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil.
authors.forename: Débora
authors.initials: D
authors.lastname: Balabram
authors.affiliation: Department of Anatomic Pathology, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil.
authors.forename: Fernanda
authors.initials: F
authors.lastname: Foureaux
authors.affiliation: Department of Anatomic Pathology, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil.
authors.forename: Simone
authors.initials: S
authors.lastname: Porto
authors.affiliation: Department of Anatomic Pathology, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil.
authors.forename: Helenice
authors.initials: H
authors.lastname: Gobbi
mesh_terms: D000912:Antibodies, Neoplasm / Q000276:immunology; D014408:Biomarkers, Tumor / Q000378:metabolism*; D001943:Breast Neoplasms / Q000378:metabolism / Q000473:pathology*; D018270:Carcinoma, Ductal, Breast / Q000378:metabolism / Q000473:pathology*; D003952:Diagnostic Imaging / Q000379:methods*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D017403:In Situ Hybridization; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000378:metabolism*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D046888:Tissue Array Analysis
chemical_list: D000912:Antibodies, Neoplasm; D014408:Biomarkers, Tumor; D018719:Erb-b2 Receptor Tyrosine Kinases
keywords: Breast cancer; Digital pathology; HER2; Immunohistochemistry; Whole slide image