TY - JOUR T1 - Comparing subjective and digital image analysis HER2/neu expression scores with conventional and modified FISH scores in breast cancer JF - Journal of Clinical Pathology JO - J Clin Pathol SP - 68 LP - 71 DO - 10.1136/jcp.2007.046763 VL - 61 IS - 1 AU - I Skaland AU - I Ă˜vestad AU - E A M Janssen AU - J Klos AU - K H Kjellevold AU - T Helliesen AU - J P A Baak Y1 - 2008/01/01 UR - http://jcp.bmj.com/content/61/1/68.abstract N2 - Background: HER2/neu expression and fluorescence in situ hybridisation (FISH) amplification have therapeutic significance.Aims: To compare subjective HER2/neu expression scores with digital image analysis (DIA) and conventional and modified FISH scores in breast cancer.Methods: Sixty HercepTest-immunostained breast carcinomas, prospectively scored as consensus 2+ and 3+ (DAKO protocol) by two observers, were analysed with DIA, and conventional (Vysis) and modified FISH scoring protocols.Results: With consensus scoring, 23 (38%) of the 60 cases were 2+ and 37 (62%) were 3+. Agreement with DIA scores was 100%. With conventional FISH scoring, 4 of the 3+ cases did not show amplification, but all of those negative cases had high HER2/neu copy numbers. With the modified FISH scoring protocol, all HercepTest immunohistochemical 3+ cases were amplified. Of the 2+ cases, 3 were amplified with the modified FISH protocol and 4 with the conventional FISH protocol.Conclusions: Modified FISH scores were better correlated with HercepTest 3+ consensus and DIA scores than were conventional FISH scores. HER2/neu DIA scoring is a cost-effective supplementary tool in surgical pathology. ER -