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How am I to have confidence in the pathology reports when two hospitals results are different?

A MyBCTeam Member asked a question 💭
Arlington Heights, IL

Stage2 ILC, HR+(Feb2025): My first biopsy came back at HER2 (2+) so they sent it off for a FISH test and that came back at HER2+. I switched hospitals and after my dblmas the pathology came back at HER2 neg but on the higher side They sent it off for a FISH test and it came back the same, HER2 neg but on the high side. How is this possible. I am so worried that we are not treating the HER2 protein. It's really hard to have confidence in these results.

October 13, 2025
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A MyBCTeam Member

Could ask that your sample gets read another facility? You wouldn’t necessarily need to go there for another opinion. You could ask your oncologist you would like a re read at Northwestern, or University of Chicago, or where ever.
Wishing you well!

October 13, 2025
MyBCTeam

It's understandable to feel concerned about different HER2 test results. HER2 testing can be complex, and results can sometimes be borderline or unclear. A score of 2+ is considered borderline and usually requires additional FISH testing for confirmation. Recent evidence suggests that some cases with a 2+ score might be Show Full Answer

It's understandable to feel concerned about different HER2 test results. HER2 testing can be complex, and results can sometimes be borderline or unclear. A score of 2+ is considered borderline and usually requires additional FISH testing for confirmation. Recent evidence suggests that some cases with a 2+ score might be treated as negative.

The variation in your results could be due to several factors:
• Different areas of the tumor being sampled
• Changes in the tumor over time
• Variations in laboratory processing methods
• Different testing technologies being used FISH testing is generally considered more accurate than IHC testing because it directly measures HER2 gene copies in the cells. Since your most recent FISH test at the second hospital confirmed the HER2-negative status, this result is likely reliable. However, it's completely valid to discuss these concerns with your oncologist. They can explain the specific implications of your results and ensure your treatment plan is appropriate for your situation.

October 13, 2025

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