By Regina H. DeFrina
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FISH has been found to be more sensitive than Southern blotting for the detection of HER2 gene amplification [79, 80]. IHC detects HER2 overexpression at the protein level, and may be affected by conditions of the testing procedures. These include time to fixation, duration of fixation, processing, denaturation, heating, antigen retrieval, the staining 16 Myra F. Barginear and Daniel R. Budman procedure used, and the interpretation of staining . Although there are antigen retrieval techniques in use, these may result in false-positive IHC results .
They suggest that the HER2-positive phenotype develops during the progression from ADH to DCIS, but may be frequently lost during progression to invasive carcinoma, perhaps as a result of HER2-directed immune response. An alternative hypothesis is that HER2-negative invasive carcinomas do not derive from DCIS, but develop from ADH via an alternative pathway. This second hypothesis is supported by evidence that HER2 status is similar in both the in situ and invasive components of a single tumor [49, 53].
Slamon and colleagues were the first to demonstrate that HER2 amplification or overexpression independently predicted a more aggressive disease behavior and a reduced overall and disease-free survival in node-positive patients . Subsequently, many studies have evaluated the prognostic significance of HER2 overexpression in breast cancer. Retrospective, multivariate analysis of data from 47 studies involving more than 15,000 patients confirmed that, in the majority (60%) of studies and the majority (67%) of patients, a HER2positive status was an independent predictor of a worse prognosis in node-positive patients.
Aggressive Breast Cancer by Regina H. DeFrina