Millions of women may benefit from new guideline recommendations created to help physicians more accurately diagnose breast cancer—thanks in part to a physician who is a breast cancer survivor.
The doctor’s story
Kimberly Allison, M.D., FCAP, was the director of Breast Pathology at the University of Washington Medical Center when she was diagnosed with an aggressive form of HER2-positive breast cancer at Stage 3. Approximately 15 to 20 percent of all newly diagnosed breast cancers are HER2-positive. She says she felt her transformation to the “other side of the microscope” began while waiting for her pathology laboratory report to come back.
“It’s the most fearful time of the whole experience; you don’t know the details or how bad your prognosis is. Your mind goes to the worst possibilities.”
That’s one reason, in the updated HER2 breast cancer testing guideline that Dr. Allison helped write, there’s a patient communications section that includes key points for doctors to discuss with patients regarding their breast cancer’s HER2 status.
The new guideline:
• Recommends all patients with invasive breast cancer have HER2 testing performed on tissue samples from the tumor
• Has specific recommendations to help ensure that the highest-quality tissue sample is used and the test performance is optimized and standardized
• Helps doctors interpret challenging cases
• Encourages that testing is performed in an accredited laboratory that follows standards set for accreditation by the College of American Pathologists (CAP) or an equivalent accreditation authority.
Pathologists diagnose and characterize the biology of each patient’s breast cancer. They work with oncologists to help select treatment options that are most appropriate for each individual based on the specific biological features of each patient’s cancer.
What is HER2 and why do we test for it?
HER2 is a protein that is expressed in increased levels in a subset of breast cancers. HER2 protein overexpression is associated with more aggressive growth of breast cancers but also with a good response to chemotherapy and HER2-targeted antibody therapies. HER2 targeted therapies have dramatically increased survival in patients with HER2-positive breast cancers. A patient becomes a candidate for HER2 targeted therapies only when there is a positive HER2 pathology test result on the tumor tissue. This testing can either be done by looking at the cancer’s HER2 protein expression or testing for the number of copies of the HER2 gene in the breast cancer. Because of the critical importance of this test in determining therapy options, it is important that every new invasive breast cancer or newly metastatic breast cancer be tested for HER2 in a standardized, validated way at an accredited laboratory to ensure accurate results.
Find an accredited lab
The CAP accredits more than 7,600 laboratories worldwide and offers a directory at www.cap.org.
To learn more about Dr. Allison, read her memoir, “Red Sunshine,” available on Amazon (www.redsunshine.org). To learn more about the new HER2 testing guideline, speak to your doctor and visit the CAP’s reference resources and publications tab, CAP guideline section, at www.cap.org.
North American Precis Syndicate