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Abstract

PATHOLOGICAL FINDINGS USING CELL-BLOCKS CAN SUCCESSFULLY BE USED IN PLACE OF TISSUE BIOPSIES IN DIAGNOSING HER2 POSITIVE TUMORS IN BREAST CANCER PATIENTS

Divya Verma, Nisha Raj, Pallavi Prasad, Rangnath Mishra, Amit Agarwal and Ram Nawal Rao*

ABSTRACT

About 12% of women are likely to develop breast cancer in course of
the life time and out of which only about one third are caused by
extremely high expression of Her2/neu. Level of Her2/neu is an
important prognostic and predictive marker in breast carcinoma and a
deciding factor while targeting with Trastuzumab. Routinely testing of
Her2/neu is performed on histological sections which is comparatively
a more invasive process. A very few reports are available which
recognized Her2/neu status on Cell Blocks (CBs) which can be done
without disturbing the tissue lumps. Aim of this study was to compare
the results of Her2/neu expression by ICC on cellblock with IHC on
corresponding histology specimen. We included 41 cases of breast carcinoma to make CBs
and performed ICC for Her2/neu. FISH for Her2/neu was performed on CB sections in 20
cases only. ICC findings corresponded with those of FISH on CBs and also with
corresponding histological specimens. Correlation between immunostaining on CBs and on
corresponding histology specimen revealed a good agreement between the two methods (with
Kappa 0.755 and specificity 96.97%). FISH of Her2/neu on CBs also showed 100%
sensitivity and 75% specificity (P < 0.001) with IHC in both groups of the samples. In
conclusions, the expression of Her2/neu on CB is a rapid, cost effective and minimally
invasive procedure for early diagnosis of breast carcinoma which could be a very useful tool
used for prognostic purposes with therapeutic implications in future.

Keywords: Breast carcinoma, Her2/neu, Cell block (CB), Immunocytochemistry (ICC) fluorescence in situ hybridization (FISH), fine needle aspiration (FNA).


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