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MEDICINE

In summary, it may be time to replace ratio reporting with sin- cancers submitted for FISH testing: experience of a reference
gle-probe ISH, and to categorize breast tumors with average HER2 laboratory using US Food and Drug Administration criteria and
gene copy number <6 and 1-2+ protein expression as HER2-low. American Society of Clinical Oncology and College of American
Recognizing this distinct genomic subtype on pathology reports will Pathologists Guidelines. J Clin Oncol. 2016;34(29):3502-3510.
doi: 10.1200/ JCO.2015.61.8983.
give a clinician critical information about a patient’s HER2 biology,
while saving time and healthcare dollars that are currently being
6. Chin SF, Wang Y, Thorne NP, et al. Using array-comparative ge-
spent trying to transform HER2-low tumors into those that can be nomic hybridization to define molecular portraits of primary
definitively called HER2-positive or HER2-negative. breast cancers. Oncogene. 2007;26(13):1959-1970.
We must await the results of the NSABP-B47 trial for guidance
as to how to best treat this subset of high-risk patients, but to rec- 7. Yeh IT, Martin MA, Robetorye RS, et al. Clinical validation of
ognize this genomic subtype now would at least identify the HER2- an array CGH test for HER2 status in breast cancer reveals that
low tumors and “give them their seat at the table,” as one of my polysomy 17 is a rare event. Mod Pathol. 2009;22(9):1169-1175.
doi: 10.1038/modpathol.2009.78.
pathology colleagues has eloquently stated.
Affiliations: Targeted Genomics and Precision 8. Gunn S, Yeh IT, Lytvak I, et al. Clinical array-based karyotyping
of breast cancer with equivocal HER2 status resolves gene copy
Pathology Services, San Antonio, Texas.
number and reveals chromosome 17 complexity. BMC Cancer.
Send correspondence to: Shelly Gunn, MD, PhD, Targeted Ge- 2010;10:396. doi: 10.1186/1471-2407-10-396.
nomics and Precision Pathology Services, 711 Navarro St, Ste 406,
San Antonio, TX 78209. E-mail: gunns@targeted-genomics.com. 9. Hansen TV, Vikesaa J, Buhl SS, et al. High-density SNP arrays
Disclosures: Dr Gunn discloses that she has been a speaker for improve detection of HER2 amplification and polyploidy in
Roche/Genentech. breast tumors. BMC Cancer. 2015;15:35. doi: 10.1186/s12885-
015-1035-1.
References
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