J Clin Pathol 67:161-167 doi:10.1136/jclinpath-2013-201819
  • Original article

HER2 testing for breast carcinoma: recommendations for rapid diagnostic pathways in clinical practice

  1. on behalf of the Translational Subgroup of the NCRI Breast Clinical Studies Group
  1. 1Department of Histopathology and Molecular Pathology, Leeds Teaching Hospitals, St James's University Hospital, Leeds, UK
  2. 2Department of Pathology, Ninewells Hospital & Medical School, Dundee, UK
  3. 3Transformative Pathology, Ontario Institute for Cancer Research, Toronto, Ontario, Canada
  4. 4NIHR University College London Hospitals Biomedical Research Centre, UCL Hospitals, London, UK
  5. 5Histopathology & Molecular Pathology, St James's University Hospital, Leeds, UK
  6. 6Queen Elizabeth Hospital, Birmingham, UK
  7. 7Dundee Cancer Centre, University of Dundee, Dundee, UK
  8. 8Breast Research Pathology, Research Oncology, Division of Cancer Studies, Kings College London, London, UK
  1. Correspondence to Dr Abeer Shaaban, Department of Histopathology and Molecular Pathology, Level 5 Bexely Wing, St James's University Hospital, Leeds LS9 7TF, UK; abeer.shaaban{at}
  • Received 3 July 2013
  • Revised 17 July 2013
  • Accepted 12 August 2013
  • Published Online First 23 September 2013


Human epidermal growth factor receptor 2 (HER2) testing is required for newly diagnosed breast cancer and advised for recurrent and metastatic breast cancer, to determine treatment planning using HER2-directed therapy in the neoadjuvant, adjuvant and advanced disease settings. Wide variation, nationally, in the turnaround time for HER2 testing may hinder equity of access for patients to both clinical trials and the timely implementation of HER2-directed therapy particularly in the neo-adjuvant setting. Process mapping from three recognised laboratories in the UK was applied to the logistics of HER2 testing in different geographic hub and spoke models. Consequently, recommendations for HER2 testing likely to facilitate access to clinical trials and timely patient care are presented.

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