serum her2 testing

[greenbear]

Is serum her2 testing done in India. Is it a substitute for FISH test. Can it tell whether there is metastasis

[manish_vkg TeamBCI]

Greanbear check this healthcare.siemens.com/siem...

[roxboxfox RadiationOncologist]

Serum Her 2 Testing was approved by FDA in 2000 and got approval for re-imbursement by Insurance companies in 2002, however it has not gained popularity and acceptance internationally.

Its indication is restricted to patients with proven and known Metastatic Her 2 positive Breast cancer who are on treatment presumably most often with Herceptin and one uses it to serially monitor the Serum Her 2 levels to assess response. The other thing is, it was approved for serial use only if pre treatment Serum Her 2 levels were elevated (> 15 ng/ml). (normal cut-off.) (So if it was < 15 ng/ml, and patient has Mets Breast cancer).. there was no point in monitoring it. But if it was high, then one could monitor it, and perhaps rising level may indicate impending progression.

The problems are that it is not fool proof, you may have wide spread mets Breast cancer, and be Her 2 +ve via FISH, but still the serum Her 2 levels may be normal.

On the contrary, you may not even have FISH +ve Her 2 Breast cancer, and Serum Her 2 levels may be high.

This False positive and negatives remain the main obstacles impeding its incorporation into broad clinical practice.

So coming to your second question,

NO ways ... can this be a Substitute for the Gold Standard which is and which will remain FISH.

(FISH Analysis is for Diagnostic purposes)

3rd question... is also a " No"

It cant reliably tell you that. Its not recommended either.

Imaging studies and clinical Examination would be the standard and most reliable tools supplemented with biopsy wherever there is doubt would be the strategy at Follow up to detect Relapse.

I do not know the answer to your First question, but could tell you so, that even if available, I would personally not request it nor suggest it to any of my patients.

Regards

Dr Rohit Malde MD, DNB, FRCR (UK)

Consultant Clinical & Radiation Oncologist

BNH-HCG Dr Balabhai Nanavati Hospital, Vile Parle, Mumbai

Apex Hospitals, Mulund (West), Mumbai

[greenbear in reply to roxboxfox]

Thanks Doctor.