HER2 IHC Interpretation Guide (Examples and Challenging Scenarios)

In this lecture I cover HER2 IHC guidelines and show some examples of the current scoring system. I also look at some cases that can present challenges for us pathologists with scoring.
I hope you find it helpful!!
-Dr. Damron
#BreastCancer #Her2 #Breastpath

[@omerali2690]

Thanks a lot sir. I know there are not many views but your presentations are extremely helpful and valuable for us, trainees.

[@adamronMD]

Glad to hear it!

[@Lisa_5591]

Thank you! My biopsy showed ER/PR both strong positive
HER2 Negative. Just had an SMX 7/27 and IHC showed Her2 2+ so equivocal, plus ER/PR positive again. Currently awaiting FiSH results. I'm hopeful it's negative. I had DCIS with lumpectomy and radiation for my 1st dx back in 2000.

[@bhanumatilab7886]

Excellent session on HER 2 IHC interpretation..Full of practical tips for routine practice. Highly grateful to you Dr. Alexander Damron

[@guruspath4291]

Very informative. Thanks doc!

[@حانیهرفیعپور]

Thanks a lot it was very helpful

[@avanaavan2575]

Thanks Sir for this highly informative lecture :)

[@adamronMD]

Most welcome!!

[@madhuk5449]

Fantastic presentation

[@umarsadique6207]

it was very interesting thanks a lot Dr.

[@sujathabalija2254]

Excellent thank you

[@praneethbablu2511]

thank you!!

[@moniashek2137]

Thank you!

[@samiahoucinat9492]

I mean some cases look 1+but they are not faint they are strong don’t exactely fit in definition of 1+should we better call them equivocal thank you so much for your excellent le tures

[@pezoserge2672]

Thanks a lot

[@adamronMD]

Happy to help

[@MaryamAzizi-jf5lr]

In cases with weak / moderate intensity but incomplete and in less than 10 percent of tumor cells… what score do you give to this one.. it’s not in the CAP, I could find it

[@SandhyaRamachandran]

Dr.Damron, thank u so much! Extremely well explained..I always found Her 2 challenging.
At 10:01, “Barely perceptible at Low Power” ..I am assuming it to be 4X obj that you are referring to? (since at 14:01 u hv shown a 4X obj.image)

[@adamronMD]

Yes 4x!

[@SandhyaRamachandran]

@@adamronMD thank you

[@samiahoucinat9492]

Dear professor the picture show strong staining focally. even it is incomplete in more than 10 % but it doesn’t fit in definition of score 1+because it is not faint. Can we call it equivocal. As it doesn’t fit all n o. Not in 1. Not in3.

[@EL-fe2of]

Hello Dr. Damron, after neoadjuvent therapy on a her2+ grading, a pathology report read residual cells 20 showing degenerative qualities, almost pcr, how close were these cells to destroyed, and how this few still remaining in your opinion? Less than 1mm in tumor bed -(or to any other qualified opinion) Thanks

[@OmarJaber-g4s]

thanks for the nice lecture. I have a case of well differentiated carcinoma, grade1 with tubular features that is showing a moderaTe basal/bassolateral staining. would you call it 2+ and send it for FISH?

[@adamronMD]

The only time we really should consider basolateral staining in the breast equivocal is in micropapillary carcinomas. If you are seeing this pattern in a tubular carcinoma then it is not complete and should be scored as 1+

[@Slnagurung]

Hi Dr Damron. How will we be able to differentiate the location of HER2 staining? such as cytoplasmic, membranous or nuclear. I am finding it hard! Could you please explain? thank you

[@sumanapaul2174]

I guess as HER2 is a receptor,it should be present in membrane.

[@adamronMD]

The HER2 staining we score is based on membrane staining. Any cytoplasmic staining should not influence your score!

[@avanaavan2575]

Hello what do you recommend for me to start with as a beginner through breast pathology??? I have little basic information about pathology. Thanks

[@adamronMD]

The Molavi surgical pathology book is a great beginner book for basic histology!

[@avanaavan2575]

@@adamronMD THANKS A LOT FOR YOUR RESPONCE :)

[@givepeace2007]

Moses Nabem Agwa

[@sujathabalija2254]

Excellent thank you