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.