Thread by @DrRolaAli

1/4
Opinion appreciated ❓
Qs related to HER2

I got this breast cancer to perform HER2 FISH, with the Dx of invasive lobular carcinoma

See next for IHC and FISH👇🏼

#breastpath #breastcancer @kis_lorand @MBBS_Pathology @DrGeeONE @nusrat_xahra @tralimiguel @OSUcat03

2/4
It is negative for e-cadherin so that’s good but it was graded as 2 (probably 3+3+1).

So first Qs:
Wouldn’t you call this pleomorphic ILC or would just give a grade on bx?

3/4

HER2 IHC was called equivocal (therefore sent for FISH)
ER= 90%
PR= 10% weak to mod

See next

4/4

FISH results:
Avr HER2 = 3.07
Avr CEP17= 1.30
Ratio= 2.36

According to 2018 guidelines these cases of “monosomy” with HER2 <4 and ratio >2 should be regarded as negative if the IHC is 0,1,2+

So this case should be negative overall, unless we upgrade IHC. What do u think?

@jennpincus @EdiBrogi @LizaMQuintana @kriyer68 @ZhaiJim

@kis_lorand @MBBS_Pathology @DrGeeONE @nusrat_xahra @tralimiguel @OSUcat03 @threadreaderapp unroll