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Understanding Pathology Results
Questions explaining and understanding pathology results.
3,073 Ask a Question

AskedPublicly Submitted Question
1/28/2012Re: HER 2 testing. (IHS vs FISH methods).

Believe NCCN recommendations are:
HER2 test results are interpreted as follows:
HER2 positive status is IHC 3+ or FISH positive
HER2 negative status is IHC 0, 1+ or FISH negative
A borderline IHC result of 2+ should be followed by performing a FISH test.
A borderline FISH result of an average HER2 gene/chromosome 17 ratio of 1.8 to 2.2 (or an average of greater than 4 to less than 6 HER2 gene copies/cell) should be followed by one of the following:
Counting additional cells in the tissue sample
Retesting with FISH
Performing an IHC test


How concerned should one be to have the other test (by the other method) if one is
negative or positive by IHS or FISH?
Should only borderline tests be repeated or re-checked by other method?
How is HER 2 tested for at Johns Hopkins? Thank you.
RepliedJHU's Breast Center Reply
1/28/2012we do follow NCCN recommendations. So if IHC is questionable FISH is ordered. Additionally, you want a BREAST pathologist doing all of the pathology evaluation, no matter what they are looking for under the microscope.

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