Concordance between of Immunohistochemistry and Dual in Situ Hybridization for Assessment of HER-2 in breast cancer in Hatyai hospital
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Abstract
Introduction: Trastuzumab is a targeted therapy in the treatment of HER2-positive breast cancer that can reduce the risk of recurrence and death. However, it is associated with cardiac toxicity. In some cases, caused discontinuation of treatment. So, the accurate assessment of breast cancer prognostic markers by immunohistochemistry (IHC) is essential to identify patients that can benefit from anti-HER2 targeted therapies.
Objective: To investigate the concordance rate between immunohistochemistry (IHC) and Dual in-situ hybridization (DISH) for assessment of HER2 status in breast cancer patients of Hatyai Hospital, Songkhla province, Thailand.
Methods: This study was a retrospective study. The data that were selected according to the following criteria: (1) included breast cancer female-patients, (2) analyzed patient’s pathology reports between November 2021 to February 2024, (3) used both IHC (scoring 2+ and 3+) and DISH to identified HER2 status and (4) these techniques performed by Department of Pathology, Hatyai Hospital. 134 patient’s reports were applied in this study. The concordance between the two methods was then statistically evaluated by using kappa coefficient.
Results: Overall concordance rates of IHC 2+ and 3+ were 76.5% with a Kappa coefficient of 0.507 (p<0.001) that showed high concordance. The concordance rate was 98.5% for IHC 3+ and 47.8% for IHC equivocal 2+.
Conclusion: The concordance rate of IHC positive 3+ and IHC equivocal 2+ showed extremely high and low concordance rate, respectively. Regarding the results of IHC 3+ breast cancer patients could be immediately treated with targeted therapy (Trastuzumab) without DISH confirmation. Nevertheless, further DISH study should be limited to IHC 2+ for confirming and excluding HER2 amplification before determining to treated with targeted therapy.
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