ERBB2 (HER2/neu) Gene Amplification by FISH with Reflex, Tissue
Ordering Recommendation
Aid in prediction of response to HER2-directed therapy in patients with breast carcinoma or gastroesophageal adenocarcinoma. Use to confirm equivocal HercepTest (2+) immunohistochemistry (IHC) result.
New York DOH Approval Status
Specimen Required
Tumor tissue.
Formalin fix (10 percent neutral buffered formalin) and paraffin-embed tissue. Fixative duration: 6-72 hours. Protect paraffin block from excessive heat. Transport block or 7 unstained (4 micron thick sections) positively charged slides in a tissue transport kit (ARUP supply #47808) available online through eSupply using ARUP Connect™ or contact ARUP Client Services at (800) 522-2787 (kit recommended but not necessary). (Min 4 slides)
Room temperature. Also acceptable: Refrigerated. Ship in cooled container during summer months.
Paraffin block with no tumor tissue remaining. Specimens fixed in any fixative other than 10 percent neutral buffered formalin. Decalcified specimens. Specimens with fixation delayed for more than one hour. Tissue fixed or less than 6 hours of greater than 72 hours.
Include surgical pathology report.
If multiple specimens (blocks or slides) are sent to ARUP, they must be accompanied by one of the following: an order comment indicating that the ARUP pathologist should choose the specimen most appropriate for testing (e.g., "Choose best block"), or individual orders for each sample submitted. A Pathologist Block Selection Fee (ARUP test code 3002076) will be added to orders that utilize the first option. If multiple specimens are sent to ARUP without a request for pathologist block/slide selection or individual orders, they will be held until clarification is provided.
Ambient: Indefinitely; Refrigerated: Indefinitely; Frozen: Unacceptable
Methodology
Fluorescence in situ Hybridization (FISH)
Performed
Mon-Fri
Reported
3-9 days
Reference Interval
Interpretive Data
Refer to report. ARUP uses the most recent ASCO/CAP interpretation criteria for evaluating ERBB2 (HER2) status.
FDA
Note
Breast tissue results of FISH group 2, 3, or 4 will be reflexed to ERBB2 (HER2/neu) (HercepTest) with Interpretation by Immunohistochemistry, Tissue (ARUP test code 0049174). Additional charges apply. Gastric and other non-breast tissue with indeterminate results will be reflexed to an alternate probe in an effort to resolve amplification status. Additional charges apply.
Hotline History
CPT Codes
88377, if reflexed add 88360 or 88377
Components
Component Test Code* | Component Chart Name | LOINC |
---|---|---|
0049241 | ERBB2 (HER2) by FISH | 42783-1 |
3005658 | Sample Adequacy | |
3005659 | Fixative Used | |
3005660 | Time from Bx to Fixative | |
3005661 | Duration of Fixation | |
3005662 | ERBB2 Reference Number | |
3005663 | ERBB2 Tissue Source |
Aliases
- c-erbB2 FISH
- CEP17
- ERRB2 FISH
- HER-2/neu FISH
- Her-2/neu Gene Amplification or Overexpression
- HER2/CEP17 Ratio