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Biopsy (HER2 3+) vs Surgical specimen (HER2 0)? What this means?

mlatiti Member Posts: 2

Hi all,

I'm new on this forum. I have this dilemma about my HER2 status.

Pathology report from biopsy gives HER2 3+, while pathology report from surgical specimen is HER2 0. This is very strange as these two results for HER2 are completely the opposite. Is this theoretically possible and what that means, especially in terms of chemotherapy, should I receive one or not? Or maybe one of these two reports are false? Or some other explanation...

Anyone have a clue?

Thank you very much.


  • maggie15
    maggie15 Member Posts: 756

    Mlatiti, was your biopsy specimen done at the same lab as your surgical specimen? My biopsy pathology did not match my surgical pathology. The biopsy path was done at my local rural hospital where one pathologist does everything while my surgical path was done at a large cancer center where the signing pathologist looks at nothing but breast cancer. I figured the second one was correct based on the expertise of the doctor, but my breast surgeon had a third (breast cancer only) pathologist give a second opinion on the biopsy slide. That second opinion matched my surgical pathology. You might ask your doctor about doing a FISH assay since that is the definitive standard for HER2 level. I went from HER2 0 to HER2 2+ equivocal, HER2- by FISH. Make sure you bring up the discordant path reports when you see your doctor. I hope your treatment goes well.

  • mlatiti
    mlatiti Member Posts: 2

    Thank you Maggie15. My biopsy specimen was tested by a different lab, so I gave it now to the same pathologist who has done surgical specimen, as he is highly specialized in breast cancer pathology. Hope I will get some clarity after this test.

    Hope your treatment is going well too? I suppose you are not receiving any chemotherapy since you are Her2- ?

  • maggie15
    maggie15 Member Posts: 756

    Hi Mlatiti, Thankfully I did not need chemo. My OncotypeDX (only used if ER+ and HER2-) was one point less than the score for chemo being recommended so I lucked out there as well. Hopefully you will be able to skip chemo, but most everyone who needs it gets through it.

    I'm glad the pathologist specialized in breast cancer is having a look at your biopsy specimen. My local hospital/clinic is fine for anything simple, but if I have a complicated medical problem I'll travel a couple of hours to a larger facility.

    I hope you get good news from the second opinion. Let me know.

  • mender
    mender Member Posts: 3

    Hi ,.I do not if I'm in the right forum for this question.

    I was wondering if any one know about blood dna test ( liquid biopsy) called Signatara


  • maggie15
    maggie15 Member Posts: 756

    Hi mender - This thread is about a difference between the pathology of the biopsy specimen and the actual tumor. You might want to start a new thread about the Signatara test in Tests, Treatments and Side Effects so that you can get answers to your question.

  • mudawon
    mudawon Member Posts: 2

    my biopsy was HER2 positive and my surgical specimen was negative. The tumor board attributed it to TCHP suppressing HER2 clones. Therefore, I had 14 Kadcyla treatments and just started Nyrlynx. I am also ER+