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Assessment of HER 2 status in breast cancer biopsies is not affected by accelerated tissue processing
Author(s) -
Bulte Joris P,
Halilovic Altuna,
Kalkman Shona,
Cleef Patricia H J,
Diest Paul J,
Strobbe Luc J A,
Wilt Johannes H W,
Bult Peter
Publication year - 2018
Publication title -
histopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.626
H-Index - 124
eISSN - 1365-2559
pISSN - 0309-0167
DOI - 10.1111/his.13507
Subject(s) - breast cancer , medicine , biopsy , immunohistochemistry , fixation (population genetics) , multiplex , histology , pathology , kappa , core biopsy , cancer , biology , bioinformatics , population , linguistics , philosophy , environmental health
Aims To establish whether core needle biopsy ( CNB ) specimens processed with an accelerated processing method with short fixation time can be used to determine accurately the human epidermal growth factor receptor 2 ( HER 2) status of breast cancer. Methods and results A consecutive case–series from two high‐volume breast clinics was created. We compared routine HER 2 immunohistochemistry ( IHC ) assessment between accelerated processing CNB specimens and routinely processed postoperative excision specimens. Additional amplification‐based testing was performed in cases with equivocal results. The formalin fixation time was less than 2 h and between 6 and 72 h, respectively. Fluorescence in‐situ hybridisation and multiplex ligation‐dependent probe amplification were used for amplification testing. One hundred and forty‐four cases were included, 15 of which were HER 2‐positive on the routinely processed excision specimens. On the CNB specimens, 44 were equivocal on IHC and required an amplification‐based test. Correlation between the CNB specimens and the corresponding excision specimens was high for final HER 2 status, with an accuracy of 97% and a kappa of 0.85. Conclusions HER 2 status can be determined reliably on CNB specimens with accelerated processing time using standard clinical testing methods. Using this accelerated technology the minimum 6 h of formalin fixation, which current guidelines consider necessary, can be decreased safely. This allows for a complete and expedited histology‐based diagnosis of breast lesions in the setting of a one‐stop‐shop, same‐day breast clinic.