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Joan M · 07-23-2009, 05:28 PM

Tonya,

Fish is a more precise test than the IHC, or immunohistochemtry, test.

Usually the IHC is done first and if it comes back 2+, it's considered inconclusive and then subjected to the Fish test. IHC 3+ is usually considered to be HER2+, but I think that now even if the result is HER2 3+ the Fish test may still be used as a second test.

In any case, I don't blame you for wanting to make absolutely sure of your HER2 status. Otherwise, what's the point? You could go to another facility and have them test your status by getting a tissue sample (not the slides) from your mastectomy. They would probably do both an IHC test and then a Fish test.

And I would agree with Debbie about the +++ part, and perhaps you can get a copy of your original pathology report to find out which tests were actually done to determine your HER2 status.

Joan

07-23-2009, 05:28 PM	#17
Joan M Senior Member Join Date: Oct 2007 Posts: 1,851	Tonya, Fish is a more precise test than the IHC, or immunohistochemtry, test. Usually the IHC is done first and if it comes back 2+, it's considered inconclusive and then subjected to the Fish test. IHC 3+ is usually considered to be HER2+, but I think that now even if the result is HER2 3+ the Fish test may still be used as a second test. In any case, I don't blame you for wanting to make absolutely sure of your HER2 status. Otherwise, what's the point? You could go to another facility and have them test your status by getting a tissue sample (not the slides) from your mastectomy. They would probably do both an IHC test and then a Fish test. And I would agree with Debbie about the +++ part, and perhaps you can get a copy of your original pathology report to find out which tests were actually done to determine your HER2 status. Joan __________________ Diagnosed stage 2b in July 2003 (2.3 cm, HER2+, ER-/PR-, 7+ nodes). Treated with mastectomy (with immediate DIEP flap reconstruction), AC + T/Herceptin (off label). Cancer advanced to lung in Jan. 2007 (1 cm nodule). Started Herceptin every 3 weeks. Lung wedge resection April 2007. Cancer recurred in lung April 2008. RFA of lung in August 2008. 2nd annual brain MRI in Oct. 2008 discovered 2.6 cm cystic tumor in left frontal lobe. Craniotomy Oct. 2008 (ER-/PR-/HER2-) followed by targeted radiation (IMRT). Coughing up blood Feb. 2009. Thoractomy July 2009 to cut out fungal ball of common soil fungus (aspergillus) that grew in the RFA cavity (most likely inhaled while gardening). No cancer, only fungus. Removal of tiny melanoma from upper left arm, plus sentinel lymph node biopsy in Feb. 2016. Guardant Health liquid biopsy in Feb. 2016 showed mutations in 4 subtypes of TP53. Repeat of Guardant Health biopsy in Jana. 2021 showed 3 TP53 mutations, BRCA1 mutation and CHEK2 mutation. Invitae genetic testing showed negative for all of these. Living with MBC since 2007. Stopped Herceptin Hylecta (injection) treatment in March 2020. Recent 2021 annual CT of chest, abdomen and pelvis and annual brain MRI showed NED. Praying for NED forever!!