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Dr. Carney,
Thank you so much for your time. You stated:
Studies have now shown that 10-40% or metastatic breast cancer patients with a negative IHC or FISH test can have an elevated serum HER-2/neu in metastatic breast cancer. As you know, patients negative by tissue testing can't receive Herceptin. The serum HER-2/neu test is not approved to select patients for Herceptin. However, if patient has an elevated serum HER-2/neu then they should have their original primary tumor re-evaluated by the approved IHC or FISH test to see if the tumor is HER-2/neu positive. If the tumor is negative or not available you should discuss with your oncologist testing a metastatic lesion for HER-2/neu positivity by IHC or FISH. If positive, then the patient can be eligble for Herceptin, if the Oncologist recommends it. Once again, the serum HER-2/neu test is not approved for selecting patients for Herceptin but can provide guidance back to the approved tissue tests.
If a patient's original tumor tested negative by IHC or FISH, why would they have their HER-2 serum tested? Is this something a stage 4 patient should ask for regardless of their original pathology?
Susan
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