Ask an Expert is a free question-and-answer service about breast cancer and breast health that is available on weekends. If you'd like to ask a question or comment, please visit us again on Saturday or Sunday. In the meantime, please search the existing topics using the search tool at the top of the page. It's quite possible that one of our many existing topics already addresses your question.
If you would like a consultation with a breast specialist at the Johns Hopkins Avon Foundation Breast Center, call 443-778-2778. It is possible to get an appointment for a second opinion within a few days of contacting us.
We hope you find the information helpful!
|Forum||Questions||Ask a Question|
|Types and Stages of Breast Cancer
Questions about the different types and stages of breast cancer.
|Asked||Publicly Submitted Question|
|4/24/2012||My original Her-2 result by immunohistochemical staining and FISH testing were both equivocal. A PT PCR analysis was then performed and demonstrated negative results. My new doctor requested a FISH analysis of the positive internal mammary lymph node removed during surgery and it came back Her-2 positive (Her-2/Cen 17 ration: 2.32). However, there is a note from the pathologist that the fixation time is unknown and may be outside the 6-48 hour recommended time frame. I know from research that this can lead to a false positive. I finished TAC in January and they would like to now start me on Herceptin. I would like to know how confident I should be in starting Herceptin based on this new information and whether I should request any additional testing. Thank you.|
|Replied||JHU's Breast Center Reply|
|4/25/2012||Thank you for turning to the Johns Hopkins Breast Center. This is a very uncertain situation indeed. I would strongly recommend a second opinion at a major academic breast center. Technically speaking the HER2 on the node is positive but just barely, and whether you would truly be a candidate for Herceptin is questionable (most trials used the biopsy/primary tumor as the only specimen to base HER2 positive or not). Fixation time can lead to false results but usually this is at the protein level (staining), not the DNA level (FISH). Depending on your first equivocal results, whether additional cells were counted on the first FISH test, etc. may help doctors decide whether this is worth taking or not. Given all these variables, I think a second opinion is warranted. Hope this helps and best wishes!|
Please note: This service is not intended to provide primary medical advice concerning specific medical care or treatment. Ask an Expert is a free service operated by health care professionals at the Johns Hopkins Avon Foundation Breast Center. Due to the volume of questions and their complexity, there are times when medical oncologists, surgeons, radiation oncologists or oncology nurses are consulted for their input. These individuals volunteer their time for this service and will respond as soon as they are able. Please do not post or send the same question to us in multiple locations or categories.