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Breast Cancer Research and Treatment

, Volume 167, Issue 3, pp 823–823 | Cite as

Reclassifying HER2-equivocal disease

  • Steven Sorscher
Letter to the Editor

To the Editor,

Based on repeat HER2 testing of a large series of invasive breast cancer cases, Xu et al. nicely demonstrated that significantly more tumors will be defined as HER2-positive based on the 2013 American Society of Clinical Oncology/College of American Pathologists (ASCO/CAP) guidelines compared to how those tumors would have been classified based on the 2007 ASCO/CAP guidelines [1].

The authors conclude that “Repeat HER2 testing clarifies HER2 status in about 50% of initial HER2 equivocal cases.” I do not believe “reclassification” should be conflated with “clarification.” Clarifying would imply that patients with tumors defined as HER2-positive based solely on one of the 2013 ASCO/CAP expanded definitions would have a significant potential of benefitting from anti-HER2 therapy, as do patients with tumors defined as HER2-positive based on the 2007 ASCO/CAP guidelines.

Reclassifying particular tumors as HER2-positive is not a clarification of status, but rather a change in status. As the authors acknowledge, the benefit of anti-HER2 therapy for patients with tumors defined as HER2- positive based solely on one of the 2013 ASCO/CAP expanded definitions remains unknown. Clinical trials are needed to determine the efficacy of anti-HER2 therapy for patients with tumors classified as HER2-positive based solely on the 2013 ASCO/SEP guidelines.

Steven Sorscher

Notes

Compliance with ethical standards

Conflict of interest

There are no relevant conflicts of interest associated with this letter.

Reference

  1. 1.
    Xu F-P, Wang K, Xu J, Chen J, Zhang Y-F, Wu H-M, Zhang M-H, Long X-X, Luo X-L, Zhang K-P, Lin D-Y, Liu Y-H (2017) Impact of repeat HER2 testing after initial equivocal HER2 FISH results using 2013 ASCO/CAP guidelines. Breast Cancer Res Treat. doi: 10.1007/s10549-017-4479-y Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  1. 1.Oncology DivisionWake Forest School of MedicineWinston-SalemUSA

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