Curious...What was your FISH and/or IHC?
 

Thank you.

Rhonda Hoffman

Hi Rhonda, mine was 15.2 - which sounds REALLY high to me. My onc said there's no "high", just positive or negative. I hope he's right!

Good thread, interested to see everyone elses' number.
Jen

Mine is 9.6

julie

Oops...
 

I guess I should have added my own. *3.16*

Rhonda Hoffman
************
DX 2/1/05
Stage 1, 1.6 cm
Node neg
Grade 3
ER-PR-
HER2+
6 rounds of dose dense TEC (Taxotere, Epirubicin, Cytoxan)
33 rads
Currently on every 3 week Herceptin until 8/06

Mine was 0! I'm 3+ via the IHC and on Herceptin.

Jen

My IHC was 3+ and my FISH was 10

My FISH was in the 6's. Not sure the exact amount.
Thanks for asking this question as I did not know how my score compared to others.
I am stage one/ just finishing my 5th month of Herceptin having completed three months of Taxotere/Herceptin
Janet

I guess I am dumb since I'm not exactaly sure what I'm looking at, but my FISH report say's:


HER-2/neu 5.42
Chromosome 17: 2.33

HER2/neu/Chromosome 17 ratio 2.32
HER2/neu Gene Ampllification POSTIVE

So. I'm not sure wheather it is 5.42 OR 2.33 ????

I still have a lot to learn I guess.

I also don't understand the Ki-67 --78%

Vicki

Dear Sailboat,

Please review my comment : http://her2support.org/vbulletin/showthread.php?t=22042 as it may answer a few questions.
Al

Mine is 7. When I asked Onc what that meant, she said it means you need to be on herceptin. I think she was having a bad day! She's normally more communicative than that!

Gina

My primary bc was IHC 3+, and my most recent recurrence to right axilla was sent for FISH and came back at with a CEP-17 ratio of 4.26.

FYI, my test was performed by PhenoPath Laboratories in Seattle WA, and included these nuggets of info in the report:



"A ratio of >2 is considered positive for gene amplification. Because signal counting is performed by the Metasystems instrument, the mean number of signals refers to signals per "computer tile" rather than tumor cell. The number of cells per tile varies as a function of tumor cell density and cell size."

And this:

"...Studies in our laboratory and others demonstrate that there exists a strong correlation between amplification of the HER-2/gene detected by FISH and overexpression of the HER-2/neu gene product as determined by immunohistochemistry, although there is a small fraction of cases (3 -5%) without gene amplification but with the presence of protein overexpression..."

My score was 6.3-Wish I could find the actual report right now.
Michelle

I'm still winning! (or is it losing???) Does anyone here know if the higher the number, the more aggressive/more responsive to Herceptin/or anything else this would relate to?

Jen,
I have heard the more aggressive the tumor, the better it responds to chemo. I truly don't know if the same goes for herceptin but I hope so.
Michelle

Yes, Saleboat..
I'm surprised you are on Herceptin since it seems IHC 3+ needs to be confirmed for her2 positivity by FISH test.

IHC +3 - do not need FISH
 

Hi Rich -
Maybe most docs would want to reconfirm for HER2 by FISH if the IHC was only ++ or less, but if it is +++ by IHC we get Herceptin.

I was HER2+++ by IHC at my diagnosis and have never had the FISH, even for my mets. I have responded well on Herceptin and that seems to be good enough for my med onc.

It seems that a very positive IHC indicates high overexpression and we go from there. But it would be interesting to know my FISH number - just to go with all the other numbers in my life!!

Does anyone know a lab in California where I can have a FISH test done?
 

Does anyone know a lab in California where I could go (or send my tumor sample) as a patient and pay to have a FISH test done? I had an IHC test (3+) done at initial diagnosis 4 years ago which allowed me to get Herceptin and my oncologist doesn't think that a FISH is necessary. I understand his reasoning. However, I'm really interested in knowing what the results would be. Reading all of your results has really peaked my curiosity.

Have a blessed Christmas and a Happy New Year.
Love, Kay

information on FISH testing
 

Stanford University Hospital will usually do a complete second pathological opinion ie, looking at the slides, staining for hormonal receptors and doing FISH as well as IHC for her2neu (and perhaps Ki67) I do not know if they will do the FISH test alone. You could also try UCLA or UCSF, but they are less user-friendly in my experience.

Most hospitals which are not comprehensive cancer centers do less of the tests or even, in most cases, send the test out to various labs, whose experience and expertise are not equivalent (to be polite). That is why it has been so hard to get good info on the prognosis of patients who are her2neu positive--the testing has been so variable that it has not even been certain that they are including the correct patients. The original results of Herceptin were less than spectacular, in fact they almost gave up on developing it, because they did not have a good way to determine who was likely to benefit from it and so the initial results were hardly significant let alone impressive. Once her2neu 1+ and, then most her2neu 2+ (those who were FISH negative)patients were taken out of the trials, the true value of Herceptin became evident.

Good luck!

Re: testing for HER2. One of the recognized challenges that Oncs are facing given the advent of Herceptin use in early-stage disease is getting an accurate pathology given the two tests that are currently in use...IHC and FSH and thereby ensuring that those patients who can benefit from Herceptin actually get it.

Most tumors that are tested positive by IHC will also get a positive result on the FSH. However, there are a small number of tumors that will be IHC 3+ and test FSH negative, and are excellent candidates for Herceptin. This seemingly contradictory result may lead to a second IHC test to confirm that the first was not a false positive, which if the tests were done at low-volume testing centers, would probably be a good idea. I've also read that there are some patients who will test IHC-, but FSH +. When we read that FSH is a 'better' test, it should be concluded that it is a more accurate test of what it measures, and is subject to fewer false positives/negatives than the IHC. But FSH measures HER2 in a different way than the IHC test does and FSH cannot be considered definitive in 100% of cases.

I've come to the conclusion is that these tests are best read in concert, and that neither should be used alone as the definitive determinant of whether or not to use Herceptin. Also, that it may make a lot of sense to have one's pathology done by a high-volume lab that has a lot of experience with these two tests.