Reliability of human epidermal growth factor receptor 2 immunohistochemistry in breast core needle biopsies.
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Reliability of human epidermal growth factor receptor 2 immunohistochemistry in breast core needle biopsies. / Lebeau, Annette; Turzynski, Andreas; Braun, Susanne; Behrhof, Wera; Fleige, Barbara; Schmitt, Wolfgang D; Grob, Tobias; Burkhardt, Lia; Hölzel, Dieter; Jackisch, Christian; Thomssen, Christoph; Müller, Volkmar; Untch, Michael.
In: J CLIN ONCOL, Vol. 28, No. 20, 20, 2010, p. 3264-3270.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Reliability of human epidermal growth factor receptor 2 immunohistochemistry in breast core needle biopsies.
AU - Lebeau, Annette
AU - Turzynski, Andreas
AU - Braun, Susanne
AU - Behrhof, Wera
AU - Fleige, Barbara
AU - Schmitt, Wolfgang D
AU - Grob, Tobias
AU - Burkhardt, Lia
AU - Hölzel, Dieter
AU - Jackisch, Christian
AU - Thomssen, Christoph
AU - Müller, Volkmar
AU - Untch, Michael
PY - 2010
Y1 - 2010
N2 - PURPOSE: Core needle biopsies (CNBs) are widely used to determine human epidermal growth factor receptor 2 (HER2) status in breast cancer. Recent publications reported up to 20% false-positive results on CNBs if immunohistochemistry (IHC) is compared with fluorescent in situ hybridization (FISH). To clarify, if confirmation of IHC positivity by FISH is generally required, we analyzed the reliability of IHC positivity on CNBs versus surgical specimens in a multi-institutional study. PATIENTS AND METHODS: Five pathologic laboratories contributed to this study by performing IHC on 500 CNBs and the corresponding surgical specimens overall. If IHC revealed score 2+ or 3+, HER2 status was confirmed by FISH in a central laboratory. We compared evaluation according to US Food and Drug Administration-approved scoring criteria and recently published American Society of Clinical Oncology (ASCO)-College of American Pathologists (CAP) guidelines. RESULTS: CNBs scored 3+ revealed five false-positive results if scoring followed the US Food and Drug Administration criteria (five of 40; 12.5%) and two false-positives in terms of the ASCO-CAP criteria (two of 33; 6.1%). IHC was false negative in one CNB only. By contrast, IHC on surgical specimens revealed five false-negative results, but only one false-positive result (one of 35; 2.9%) if scored following US Food and Drug Administration-approved criteria. With the aid of the ASCO-CAP criteria, false-positive IHC results were obtained in only one of the five participating institutions. CONCLUSION: IHC 3+ scores on CNBs proved to be reliable in four of the five participating institutions if scoring followed the ASCO-CAP criteria. Therefore, accurate determination of HER2 status in breast cancer is possible on CNB using the common strategy to screen all cases by IHC and retest only 2+ scores by FISH. Prerequisites are quality assurance and the application of the new ASCO-CAP criteria.
AB - PURPOSE: Core needle biopsies (CNBs) are widely used to determine human epidermal growth factor receptor 2 (HER2) status in breast cancer. Recent publications reported up to 20% false-positive results on CNBs if immunohistochemistry (IHC) is compared with fluorescent in situ hybridization (FISH). To clarify, if confirmation of IHC positivity by FISH is generally required, we analyzed the reliability of IHC positivity on CNBs versus surgical specimens in a multi-institutional study. PATIENTS AND METHODS: Five pathologic laboratories contributed to this study by performing IHC on 500 CNBs and the corresponding surgical specimens overall. If IHC revealed score 2+ or 3+, HER2 status was confirmed by FISH in a central laboratory. We compared evaluation according to US Food and Drug Administration-approved scoring criteria and recently published American Society of Clinical Oncology (ASCO)-College of American Pathologists (CAP) guidelines. RESULTS: CNBs scored 3+ revealed five false-positive results if scoring followed the US Food and Drug Administration criteria (five of 40; 12.5%) and two false-positives in terms of the ASCO-CAP criteria (two of 33; 6.1%). IHC was false negative in one CNB only. By contrast, IHC on surgical specimens revealed five false-negative results, but only one false-positive result (one of 35; 2.9%) if scored following US Food and Drug Administration-approved criteria. With the aid of the ASCO-CAP criteria, false-positive IHC results were obtained in only one of the five participating institutions. CONCLUSION: IHC 3+ scores on CNBs proved to be reliable in four of the five participating institutions if scoring followed the ASCO-CAP criteria. Therefore, accurate determination of HER2 status in breast cancer is possible on CNB using the common strategy to screen all cases by IHC and retest only 2+ scores by FISH. Prerequisites are quality assurance and the application of the new ASCO-CAP criteria.
KW - Humans
KW - Female
KW - Biopsy, Needle
KW - Reproducibility of Results
KW - Immunohistochemistry
KW - Guidelines as Topic
KW - Breast Neoplasms metabolism
KW - False Negative Reactions
KW - False Positive Reactions
KW - In Situ Hybridization
KW - Receptor, erbB-2 metabolism
KW - Humans
KW - Female
KW - Biopsy, Needle
KW - Reproducibility of Results
KW - Immunohistochemistry
KW - Guidelines as Topic
KW - Breast Neoplasms metabolism
KW - False Negative Reactions
KW - False Positive Reactions
KW - In Situ Hybridization
KW - Receptor, erbB-2 metabolism
M3 - SCORING: Zeitschriftenaufsatz
VL - 28
SP - 3264
EP - 3270
JO - J CLIN ONCOL
JF - J CLIN ONCOL
SN - 0732-183X
IS - 20
M1 - 20
ER -
