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HER-2 testing in the UK: consensus from a national consultation
  1. Mitch Dowsett (mitch{at}icr.ac.uk)
  1. The Royal Marsden Hospital, United Kingdom
    1. Andrew M Hanby
    1. Pathology and Tumour Biology, Leeds University, United Kingdom
      1. R Laing
      1. St Lukes Cancer Centre, Guildford, Surrey, United Kingdom
        1. Rosemary Walker
        1. Breast Cancer Research Unit, University of Leicester, United Kingdom

          Abstract

          Objective: To gain an understanding of current attitudes among oncologists and pathologists to prospective HER2 testing in breast cancer and to gauge whether a national consensus exists regarding extent and quality of testing.

          Design: Qualitative study, with semi-quantitative components, using emailed questionnaires and open-ended discussion documents.

          Participants: 186 relevant specialists, including 76 breast oncologists and 99 pathologists, representing all but three of the UK cancer networks.

          Results: A strong consensus was seen in favour of universal, non-selective testing for HER-2 at the point of breast cancer diagnosis. Similarly, an overwhelming majority of participants agreed that, to optimise the quality of test results, all laboratories undertaking HER2 testing should be CPA-accredited, should participate in the recognised national external quality assessment scheme (UK NEQAS) and should carry out a formal annual audit of its testing service. A further recommendation that testing be restricted to laboratories undertaking a minimum 250 tests per annum for immunohistochemistry (IHC) and 100 tests per annum for in-situ hybridization techniques (FISH or CISH) met with majority support. However, this was not a clear consensus; a significant minority of participants favoured continued use of local services falling short of these criteria.

          Conclusion: This study was successful in gauging national specialist opinion regarding the extent and quality assurance of HER2 testing in the UK.

          • HER2
          • consensus
          • immunohistochemistry

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