Response to Melinda
 

Melinda--

Here is post from Kate to the same question on another thread:

"There are two tests for HER-2:

IHC test (IHC stands for ImmunoHistoChemistry) The IHC test shows if there is too much HER-2 receptor protein in the cancer cells. The results of the IHC test can be 0 (negative), 1+ (negative), 2+ (borderline), or 3+

FISH test (FISH stands for Fluorescence In Situ Hybridization) The FISH test shows if there are too many copies of the HER-2 gene in the cancer cells. The results of the FISH test can be "positive" (extra copies) or "negative" (normal number of copies).

Find out which test for HER-2 you had. This is important. Only cancers that test IHC "3+" or FISH "positive" will respond well to therapy that works against HER-2. An IHC 2+ test result is called borderline. If you have a 2+ result, you can and should ask to have the tissue tested with the FISH test." End of Kate's post.

On that same thread, I noticed a response from another member stating that her doctor also said FISH is either "positive or negative; the actual numbers don't count." Her doctor recommended, instead, that she get the Oncogene test to see how aggressive the cancer might be. I was surprised by that, as my understanding has been that the Oncogene test is run only if a woman is ER or PR positive, and that it is not run for those, like so many of us, who are ER and PR negative and HER2 positive.

One other non-scientific response from me. I suspect that doctors say the FISH numbers don't count simply because they don't know if they do or they don't. Obviously, it counts if you have more than two copies of the gene, so it would seem intuitive that if you have many more copies it must mean something. I say this, knowing that I have more than double the normal, at 4.7.

I am Her2+++. Fish was not done.
Marlys

IHC 3+, Fish+. Being FISH+ was no surprise to anyone. Doc doesn't believe in worrying us with the minutiae of the actual score On one hand I think I would like all the info, but on the other I would have flipped if I closely tracked my MUGA dropping.

Grace, I think oncotype is geared to early stage, node negative. Almost all HER2+ yield high onco score with ER/PR- not helping.

Looking forward to the day thet have all the answers. Bev

I was only tested by FISH and -- 9.6. Also very high ki67, myotic rate, the whole ball of wax. My path report was a column of "unfavorables." The tumor grew VERY fast.
Almost at two years and NED.
Linda.

Grace... thanks , you gave me motivation to research
 

Grace
I just came across an interesting article that may explain the differences in FISH testing by different labs. http://www.nccn.org/patients/fact_sheet.asp. I will however ask my ONC what my ratio is. I found it curious that he just said 'positive"
Melinda

It's a very good site.
 

Thanks Melinda. Jill's husband posted the same site today on another thread and I found it excellent, the best explanation I've read to date of HER2 and the various ways of testing for over-expression and amplification.

My numbers
 

I don't know what IHC is, but my FISH score for HER2 was 4.7 and I am currently undergoing herceptin, taxotere and carboplatin.
harrie

Hi, Michele.
My FISH results:
Amplified
Her-2/cen 17 ratio = 10.5
Average Her-2/neu copies per cell: 20.0
Average cen 17 copies per cell: 1.9
I don't see any IHC numbers on my path report.

My Fish Test Was 7.4. I've Also Wondered About The Scores. My Oncologist Said It Didn't Make A Difference What The Score Was. (since Have Change Oncologist And Will Ask Her At My Next Visit.)
My Signature Is My Journey.

IHC2 and FSH 8.3 (original tumor) - took Herceptin

IHC2 and FSH 9.1 (recurrence) - will take Herceptin

- Anna

Hi Michele!
IHC 3+, FISH 4.9

Hi! My IHC was considered "borderline" 2+ and my FISH is 2.1 and I was given AC x4 and Taxotere x4 with weekly herceptin and now 9 more months of herceptin by itself. I too have been trying to find out what the prognosis differences are if you are a low level her2+ versus a higher number FISH score. If anyone out there knows any info on this I would really appreciate it. Thanks to all of you for all your knowledge. Melissa