FISH Test

[skeetur]

Who ordered yours - your surgeon or the oncologist?

I've done stereotactic biopsies, lumpectomy, re-excision lumpectomy and now waiting on consult with plastic surgeon to do mastectomy and reconstruction.

The first lumpectomy show 2 very small areas of IDC ER+/PR+ with HER-2/neu 2.8+ amid much DCIS. So I assume the next step on that is FISH to check/confirm HER-2/neu status.

Should I ask surgeon to request this? Or do I wait til after mastectomy when I see oncologist?

Thanks, Skeetur

[Melinda]

My Fish test was done automatically when I had the lumpectomy. Apparently the IHC test came back a 2 which is considered either borderline or positive depending on who you talk to. If it had been a zero or a 1 a FISH test would not have been done... and maybe that circumstance is a good thing. The FISH test they say is more exact they say. In my circumstance, Early stage1, no node involvement, clear margins ER+ all was good unitl the FISH test found an overstimulation of the HER2 gene. My Onc suggested the ONCOTYPE test and I am currently waiting for the results. I will try to keep you posted. My thoughts are with you. I know that the hardest part of all this is waiting for the knwoledge so that you can make informed decisions. Hang in there... we can beat this together.
Melinda

[skeetur]

Hey Melinda!

I'm going to put a call into the surgeon to see if FISH test will/can be done. Might as well get it done while I'm waiting for mastectomy w/ reconstruction.

I did check with insurance on the Oncotype Dx test and my primary doesn't cover it as "experimental" and secondary has paid for it i n certain cases thought they won't say yes until they get justification for it from a doctor. Sigh. LOL!

Seems like all I've done thus far is wait with the exception of the initial biopsies. Those were done the day after mammogram showed something. It was 3 weeks to lumpectomy. One week to post-op visit and path report. Then another 3 weeks to re-excision lumpectomy. Another week to post-op visit and 2nd path report. Now, wait 10 days til plastic surgery consult then that doc will have to coordinate with breast surgeon to match calendars, OR, schedules, dates, times, etc. Argh! I assume no mastectomy and reconstruction at this point til mid-March.... I'd just love to get one part of this journey behind me!!

We will beat this together!

Thanks so much, Skeetur

[Melinda]

I have some information concerning the ONCO test. Some one wrote to me from the Komen message boards saying
"Genomic Labs will submit 3 appeals on your behalf. My understanding is that if all appeals are denied and you are responsible for payment, Genomic Labs has a payment plan or a plan where they will even write it off (I believe your income cannot be more than $93,000
per year for a family of 4-5). This also applies to any balance you have left over if insurance pays some of it. The cost is $3,460.00. Also the process takes a long time. The phone number for Genomic is 1-877-235-4349. They will assign a case manager to you. They have been wonderful and very helpful. Good luck on this. "
I know its a huge hurry up and wait scenario. That is why these boards are so essential... its helps us with our sanity as well as providing support. I am waiting for the ONCO test because I am HER2 ++ from the IHC test. I only know that the FISH did come up poistive to what degree if they even have degrees, hence the ONCO. If there is only a small percentage of improvement with chemo then I need to think about eveything. Please remember that each of us has different patholgy and your DR is the best one to discuss all of this. Please keep in touch. We all are in this together!

[CPA]

skeetur,

Are you sure that your results were IHC? Generally, IHC is scored 0 - 1 - 2 - 3 while FISH is a ratio, with it being common for a score like yours of 2.8.

Good luck.

[skeetur]

>Are you sure that your results were IHC? Generally, IHC is scored 0 - 1 - 2 - 3 >while FISH is a ratio, with it being common for a score like yours of 2.8.

The results I have do not say IHC or FISH. They have my ER and PR status and then HER-2/neu underneath. It says 2.8+ and then under interpretation it says "Overexpression" and it says that < 2.0 is favorable and that > 2.0 is unfavorable.

Skeetur

[tousled1]

When your surgeon does your initial biopsy it is usually checked for ER/PR status and HER2 status. When you have your surgery the biopsy again is checked for ER/PR and HER2 status along with a bunch of other things.