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Interobserver variability in HER-2/neu reporting on immunohistochemistry in breast carcinomas
JPMA. the Journal of the Pakistan Medical Association
|March 20, 2014
Summary
Interobserver variability in human epidermal growth factor receptor 2 (HER2/neu) scoring is significantly higher in untrained histopathologists. This impacts patient selection for Herceptin therapy.
Area of Science:
- Oncology
- Pathology
- Biomarker Analysis
Background:
- Accurate human epidermal growth factor receptor 2 (HER2/neu) assessment is crucial for breast cancer treatment.
- Interobserver variability in HER2/neu immunohistochemistry (IHC) scoring can affect clinical decisions.
Purpose of the Study:
- To compare HER2/neu IHC scoring agreement between trained and untrained general histopathologists.
- To quantify interobserver variability in HER2/neu assessment in invasive breast carcinoma.
Main Methods:
- Retrospective analysis of 120 invasive breast carcinoma cases with varying HER2/neu scores (0, 1+, 2+, 3+).
- Two groups of histopathologists (trained vs. untrained) independently scored HER2/neu status using IHC.
- Kappa statistics were used to evaluate interobserver agreement.
Main Results:
- The trained group achieved perfect agreement (94% concordance, Kappa=0.96).
- The untrained group demonstrated moderate agreement (69% concordance, Kappa=0.59).
Conclusions:
- Significant interobserver variability exists in HER2/neu IHC scoring among untrained general histopathologists.
- This variability may compromise the appropriate selection of breast cancer patients for HER2-targeted therapies like Herceptin.
