Letters Section Editor: Stephen J. Lurie,
MD, PhD, Senior Editor.
To the Editor: Dr Yaziji and colleagues1 compared immunohistochemistry (IHC) and fluorescence
in situ hybridization (FISH) tests for overexpression of human epidermal growth
factor receptor-2 (HER-2). Based on the inconvenience and higher cost of FISH,
they concluded that HER-2 determination was most "efficient" by using IHC,
with FISH performed for tumors with an IHC score of 2+. FISH was not recommended
in tumors with an IHC score of 3+. Although I agree that FISH should be performed
if the IHC score is 2+, the omission of confirmatory FISH when the IHC score
is 3+ could lead to several adverse financial and ethical consequences.
Tanvetyanon T. HER-2 and Fluorescent In Situ Hybridization to Evaluate Breast Cancer. JAMA. 2004;292(3):328. doi:10.1001/jama.292.3.328-a