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Hi:
I was the original poster, who had an IHC 3+ and a FISH negative result. Since then, my oncologist and I have been trying to decide what this means. Dr. Edith Perez, who is one of the top researchers on Herceptin, feels a positive on either test could mean a benefit from Herceptin. She even commented that the IHC test, done correctly, may be a better indicator for Herceptin benefit. Not all doctors agree with her theory.
In the trials, there were a few women who were IHC 3+ and FISH negative. They were considered candidates for Herceptin and included in the trials.
As I understand it, the IHC test is looking for a protein on the outside of the cell. The FISH test is looking more at the genetic material inside the cell. So the tests are measuring two different things.
I also discovered that the local hospital, which did my original IHC test in 2002, changed the way they were doing the test in 2003 because of non-compliance with the FISH test. Insurance is turning me down for a retest so I may pay out of pocket. I think there is a very good chance that the original IHC test result of 3+ is incorrect and I was never Her2 positive. I think the IHC test should be done at a high volume, experienced lab. The FISH test is probably always done at a large reference lab.
When the tests were done, they used the tumor sample from my 2002 lumpectomy. My recent Herceptin treatments wouldn't affect the tests.
Even if I eventually come out 3+, I do not think I will begin the Herceptin again. I am now three years past my AC chemo, had many minor Herceptin side effects, and I am dealing with a cardiac issue (not caused by Herceptin). I'm at the point where the risks outweigh the possible benefits.
It's all so confusing...even for the oncologists. I've been hearing a lot of "we just don't know."
Linda
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