Comparison of IHC, FISH, ER and PR in Breast Cancer in Western Iran

Abstract

To evaluate the concordance and discordance between IHC and FISH results for detection of Her2/neu protein, analyses of ER and PR, and also evaluation of the benefit of adjuvant trastuzumab in patients diagnosed with human epidermal growth factor receptor 2 (HER2) -positive invasive ductal carcinoma enrolled onto the Herceptin adjuvant. IHC analysis of ER, PR and HER2 was performed in 133 patients of breast cancer with invasive ductal carcinoma. 90(67.6%) cases were confirmed by FISH. Statistical analysis was performed with IBM SPSS version 19, Kaplan-Meier method and log-rank test. Age mean of patients was 46.39±10.81 years (range, 24-78 years). Concordance rates between IHC and FISH were 32.4% for IHC 2+ and 81.25% for IHC 3+ (P<0.001). There were 17 and 56 patients of IHC 2+ and 3+ with ER positive and also 23 and 59 patients of IHC 2+ and 3+ had PR positive.The 83 patients had age ≤50 years and 50 patients had >50 years. Of 133 the patients, 48(36.1%) patients were treated with trastuzumab and 85(63.9%) were treated without trastuzumab. The overall survival(OS) for patients treating with trastuzumab were mean of 37.8 months and the OS for patients treating without trastuzumab were mean of 20.8 months (P<0.05). The results are that trastuzumab therapy is effective and improves the survival of HER2-positive breast cancer patients and trastuzumab therapy is effective and tolerated for breast cancer with Her-2 positive. There is a statistically significant relationship between ER positive with PR positive and ER negative with PR negative that these results need to more studies with more patients in the world.

Her-2/neu Oncogene Amplification By Fluorescence In Situ Hybridization And Protein Overexpression On Immunohistochemistry In Breast Cancer

“…Studies from Iran, Taiwan, and Switzerland reported concordance of 81.2%, 83% and 84% and discordance of 18.7%, 16.7% and 16% in cases with IHC staining 3+ and Her-2/neu FISH, respectively. 12,15,20 Studies from India showed concordance of 78% and 85% and discordance of 21.8% and 14.2%, respectively which is in stark contrast to current study. 6,13 A local study and studies from America, Iran, and Saudi Arabia reported concordance rate of 74%, 69%, 61.5% and 50%, respectively.…”

“…12,13 Studies from Switzerland, America, Spain and Iran reported gene amplification in 95%, 7.1%, 18%, and 32.4% cases while gene was not amplified in 5%, 88%, 81%, and 67.6% cases, respectively. 15,16,20,21 Studies from Turkey, Iran, and Saudi Arabia showed 23%, 27.9% and 23% and gene amplification in cases scoring 2+ immunostaining. 7,14,19 Concordance between IHC scoring 3+ and Her-2/neu gene in Indian studies, 17,18 was 93.9% and 92.9% and discordance of 3.65% and 7.1% between IHC scoring 3+ and Her-2/neu FISH, respectively.…”

Evaluation of Immunohistochemistry-Equivocal (2+) HER2 Gene Status in Invasive Breast Cancer by Silver DNA in Situ Hybridization (SISH) and its Association with Clinicopathological Variables

“…Dieci et al ( 16 ) investigated 480 breast cancer tissues with 2+ HER2, revealing that high tumor grade and high Ki67 were significantly associated with HER2 FISH amplification. Payandeh et al ( 17 ) recruited females with breast cancer at the Oncology Clinic, Kermanshah, Iran. Of the 133 patients, 37 were classified as IHC 2+ and 96 were classified as IHC 3+.…”

Breast Carcinoma – A Comparative Study of Immunohistochemistry and Fluorescence in Situ Hybridization for Her-2 Assessment and Association of ER, PR, HER-2 and Ki-67 Expression with Clinico-Pathological Parameters

“…Patients diagnosed to have infiltrating ductal carcinoma (Figure 1a) were 20 (58.82%), those with infiltrating lobular carcinoma were 13 ER status analysis showed 13 (38.24%) patients as ER-positive, and 21 (61.76%) were ER-negative. PR positive status was seen in 11 (32.35%), and PR negative was 23 (67.65%).…”