FISH numbers? I"m at Project LEAD
 

Hi, all. I'm at Project LEAD.I'm learning alot more then i thought! I'll fill you in when i get home. I have a question for a gal. i met here. What is everyone's FISH score and IHC? Let me know if your IHC was 2+ and took Herceptin thanks Michele Ulmer

I was 2.1 and they are re-running path tests to determine if I am really her2/neu positive or negative. I will get this second round of results on Monday. I started herceptin in June - have had 2 recurrences of cancer and doctor took me off Herceptin 2 weeks ago. I learned today that the her2/neu stats of mets can vary 15% from the original tumor and that leads me to believe that mets pathology should be tested for her2/neu status as well.

IHC 2+ FISH 8.6
I took late herceptin.

See signature
 

FISH results 4.7

Hi Michele,

My FISH score was 6.3. I never had the IHC test.

Karen

Proud of you Michele!
IHC 3+++, FISH positive as well although I don't know the #

IHC - 2+

FISH - 2.71 (weakly positive)

No chemo or herceptin - just surgery, tamoxifen and rads.

Just hope the medics are right!

Mcgle

fish/IHC
 

I was positive - 2+ to 3+ on my IHC, but negative on my Fish with only 40% rating. There was controversy about whether I should take Herceptin - I finally went to an Onc who would give it...

The actual reading of the test result went like this:

The Her2/neu to centromere 17 ratio was 1.62 +/- 0.71. A her2/neu to D17z1 ratio greater than 2.00 usually indicates Her2 gene amplification. The percentage of cells with a ratio of 2.00 or greater was 40%. There was an average number of 3.1 copies of the her2/neu gene.

Hi my IHC 3+++
FISH was 10

results
 

My sister was 3+ strongly positive;fish 8.2 amplified

Mine was 2.8+ on IHC. Haven't gotten FISHed yet. Hopefully soon.

Does FISH score make a difference?
 

This may be the thread to ask this question, or perhaps I'll start another. Since learning that my FISH was 4.7, I've tried to ascertain through research on the internet and asking my doctors if a higher FISH means a less positive prognosis. I have been unable to find anything regarding this. I faintly remember finding some documentation to the effect that the higher the FISH the more effective herceptin, but even that is in some doubt. I would think there must have been some research done regarding FISH numbers. If anyone out there has information regarding this issue, please write. Thanks.

Think my low FISH score was a factor in not getting herceptin. Don't think they give herceptin without chemo here in the UK.

Neither do we get the proliferation rate or the genetic make-up of the tumour. Wish we did.

It is such a minefield...

Mcgle

My FISH was 10. Grace, I also remember reading about the FISH score being high was a good indicator for having a good response to Herceptin. I certainly hope so. I will be on Herceptin for a year, once every 3 weeks after my FEC-t chemo ( 3 rounds of FEC, then 3 rounds of T- Taxotere).

Regards to all
Caya

IHC 3+ and Herceptin 2 month after chemo for 1 year.

Hi Michelle

Would love to be there with you...a goal for myself for next year! Have a great time!

her2 = 2.5 amplified
her2 copies per cell = 7.7
cen 17 copies per cell = 3.1

Stephanie C.

IHC 2+ Fish postive
 

MIchelle,
I was told by my ONC that FISH was either positive or negative... maybe you could help me understand the numbers associated with the FISHtest that others have posted. ONCO test was 23.
Just started TCH 6 rounds of TC and a year of H concurrently
Melinda

I was her2+++ with IHC. I didn't have FSH test. My husband and I spoke with 2 of the pathologists about a month or so after my dx. They remembered my case very well because it was supposedly 'unusual.' I was told that if there was any doubt they would also give FSH test; however, both said they were 100% sure I was her2+ At that time they had only been routinely testing for Her2 for about a year. My surgeon told me that since they began the testing that I was only her 3rd patient (in a year) that had tested positive.
I had been rejected from clinical trial for Herceptin for early stage bc because I also have M.S. I was fortunate that my onc. allowed me Herceptin since I was not clinically dx'd stage IV. However, after getting a couple of 2nd opinions I am not so sure that I wasn't stage IV--at least in the earliest part at time of dx. I had at least 3 different types of aggressive b.c. with lymphovascular invasion, and I had elevated tumor markers--both CEA and CA 27-29 at time of dx. In addition I had a lesion in my liver--never quite identified. There were also alot of enlarged retroperitoneal nodes with the largest measuring 2.5 cm at its greatest width. There was alot of other stuff going on as well.

My fish score was 15...this really made me worry...
Dr. Slamon believes the higher the score the better for herceptin to work.
My onc here on the East coast is not sure that is so.

Jean

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