Repeat FISH Testing of Breast Tissue Not Cost-Effective for Her-2/neu Determination

Wow this is interesting; Medscape reports Repeat FISH Testing of Breast Tissue Not Cost-Effective for Her-2/neu Determination:

Universal testing of breast cancer tissue for Her-2/neu status with fluorescence in situ hybridization (FISH), as some have proposed, does not increase the identification of candidates for Her-2/neu-directed therapy and is not cost-effective, investigators from Loyola University Medical Center in Maywood, Illinois, announced here at the American Society for Clinical Pathology 2009 Annual Meeting.

There is currently no consensus about Her-2/neu testing on specimen type, the use of multiple-specimen testing (dual testing), or the utility of universal FISH, noted lead author Kelli Ann Hutchens, MD, who is now a dermatopathology fellow at State University of New York in Brooklyn. The senior author of the study was Henry Brown, MD.

Importantly, universal FISH testing did not result in the increased identification of tumors that would potentially be trastuzumab-responsive, they reported. Nor did dual testing of the biopsy and excision specimens with IHC or FISH result in increased identification of Her-2/neu positivity.

This is significant because often labs use IHC as a screening technology, and FISH as the final determinant of Her2 positivity.  This study suggests that IHC can be used as the final determinant, saving the cost (and additional time) of the FISH assay.