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IHC KNOWLEDGE CHECK

Review consensus scored
clinical cases


Challenging clinical breast cancer cases, consensus scored by the Pathology Faculty, featuring whole slide images (WSIs) and interpretation summaries.

012 AVD-16AOZ-1069A 4B5 Ab
CHECK YOUR KNOWLEDGE

Which HER2 IHC score would you assign to this slide?

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IHC 0+

Your selected HER2 IHC score is aligned with the consensus score provided by the Pathology Faculty.

Consensus score: 0

This is a challenging case where about 10% of tumor cells display a faint/barely perceptible incomplete membranous staining. In such borderline cases, screening the slide multiple times from low (4X) to high magnification (20X-40X) is needed.

As this tumor has a poorly differentiated morphology, repeating the IHC on a different specimen, such as an excision, might be considered. A larger tissue sample from high-grade tumors might show a different IHC result from the one obtained from a tissue biopsy.

View whole slide image

Your selected HER2 IHC score is not aligned with the consensus review provided by the Pathology Faculty.

Consensus score: 0

This is a challenging case where about 10% of tumor cells display a faint/barely perceptible incomplete membranous staining. In such borderline cases, screening the slide multiple times from low (4X) to high magnification (20X-40X) is needed.

As this tumor has a poorly differentiated morphology, repeating the IHC on a different specimen, such as an excision, might be considered. A larger tissue sample from high-grade tumors might show a different IHC result from the one obtained from a tissue biopsy.

View whole slide image
015 AVD-16AOZ-4730A 4B5 Ab
CHECK YOUR KNOWLEDGE

Which HER2 IHC score would you assign to this slide?

View whole slide image
IHC 0+

Your selected HER2 IHC score is aligned with the consensus score provided by the Pathology Faculty.

Consensus score: 0

Less than 10% of tumor cells display a faint/barely perceptible and mainly incomplete membranous staining. This case could be challenging since the specifically stained tumor cells are scattered while multiple tumor cells only present a non-specific basal staining.

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Your selected HER2 IHC score is not aligned with the consensus review provided by the Pathology Faculty.

Consensus score: 0

Less than 10% of tumor cells display a faint/barely perceptible and mainly incomplete membranous staining. This case could be challenging since the specifically stained tumor cells are scattered while multiple tumor cells only present a non-specific basal staining.

View whole slide image
024 AVD-16AOZ-4198A 4B5 Ab
CHECK YOUR KNOWLEDGE

Which HER2 IHC score would you assign to this slide?

View whole slide image
IHC 1+

Your selected HER2 IHC score is aligned with the consensus score provided by the Pathology Faculty.

Consensus score: 1+

This is a challenging case with between 10% and 15% of tumor cells displaying a faint/barely perceptible and incomplete membranous staining.

View whole slide image

Your selected HER2 IHC score is not aligned with the consensus review provided by the Pathology Faculty.

Consensus score: 1+

This is a challenging case with between 10% and 15% of tumor cells displaying a faint/barely perceptible and incomplete membranous staining.

View whole slide image
026 AVD-16AOZ-6439A 4B5 Ab
CHECK YOUR KNOWLEDGE

Which HER2 IHC score would you assign to this slide?

View whole slide image
IHC 0+

Your selected HER2 IHC score is aligned with the consensus score provided by the Pathology Faculty.

Consensus score: 0

This is an interesting case where several tumor cells exhibit a faint and rarely moderate incomplete membranous staining. However, when carefully examined, the percentage of these stained tumor cells is less than 10%.

The strong staining intensity might create a false impression of a higher number of stained tumor cells.

View whole slide image

Your selected HER2 IHC score is not aligned with the consensus review provided by the Pathology Faculty.

Consensus score: 0

This is an interesting case where several tumor cells exhibit a faint and rarely moderate incomplete membranous staining. However, when carefully examined, the percentage of these stained tumor cells is less than 10%.

The strong staining intensity might create a false impression of a higher number of stained tumor cells.

View whole slide image
385 AVD-16AOZ-4037A 4B5 Ab
CHECK YOUR KNOWLEDGE

Which HER2 IHC score would you assign to this slide?

View whole slide image
IHC 2+

Your selected HER2 IHC score is aligned with the consensus score provided by the Pathology Faculty.

Consensus score: 2+

This is an interesting case where more than 10% of tumor cells display a moderate to strong incomplete basolateral or lateral membranous staining. The faint staining might mislead some to score this case 1+.

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Your selected HER2 IHC score is not aligned with the consensus review provided by the Pathology Faculty.

Consensus score: 2+

This is an interesting case where more than 10% of tumor cells display a moderate to strong incomplete basolateral or lateral membranous staining. The faint staining might mislead some to score this case 1+.

View whole slide image
386 AVD-16AOZ-5239A 4B5 Ab
CHECK YOUR KNOWLEDGE

Which HER2 IHC score would you assign to this slide?

View whole slide image
IHC 1+

Your selected HER2 IHC score is aligned with the consensus score provided by the Pathology Faculty.

Consensus score: 1+

This an interesting case with several tumor cells displaying a faint/barely perceptible and incomplete membranous staining while some are expressing a strong basolateral or lateral staining. The high intensity staining in less than 10% of tumor cells keeps this case at a lower score.

As this tumor has a poorly differentiated morphology and micropapillary features, repeating the IHC on a different specimen, such as an excision, might be considered. A larger tissue sample from high-grade tumors might show a different IHC result from the one obtained from a tissue biopsy.

View whole slide image

Your selected HER2 IHC score is not aligned with the consensus review provided by the Pathology Faculty.

Consensus score: 1+

This an interesting case with several tumor cells displaying a faint/barely perceptible and incomplete membranous staining while some are expressing a strong basolateral or lateral staining. The high intensity staining in less than 10% of tumor cells keeps this case at a lower score.

As this tumor has a poorly differentiated morphology and micropapillary features, repeating the IHC on a different specimen, such as an excision, might be considered. A larger tissue sample from high-grade tumors might show a different IHC result from the one obtained from a tissue biopsy.

View whole slide image

Related resources

View all resources

E-LEARNING

Topic 1: Clinical innovation across the HER2 pathway

Dr. Krishnamurthy presents the evolution of HER2 in clinical practice. (7 mins)

Play video

E-LEARNING

Topic 2: The spectrum of HER2 expression

Dr. Tozbikian reviews current HER2 guidelines and the significance of discrete HER2 IHC scoring. (9 mins)

Play video

E-LEARNING

Topic 3: Overcoming challenges in assessing HER2 expression across the spectrum

Dr. Hicks highlights best clinical practices for differentiating low levels of HER2. (11 mins)

Play video

GUIDE

HER2 expression in breast cancer: A comprehensive reference

A downloadable comprehensive guide to HER2 IHC scoring.

Download

E-LEARNING

Topic 1: Clinical innovation across the HER2 pathway

Dr. Krishnamurthy presents the evolution of HER2 in clinical practice. (7 mins)

Play video

E-LEARNING

Topic 2: The spectrum of HER2 expression

Dr. Tozbikian reviews current HER2 guidelines and the significance of discrete HER2 IHC scoring. (9 mins)

Play video

E-LEARNING

Topic 3: Overcoming challenges in assessing HER2 expression across the spectrum

Dr. Hicks highlights best clinical practices for differentiating low levels of HER2. (11 mins)

Play video

GUIDE

HER2 expression in breast cancer: A comprehensive reference

A downloadable comprehensive guide to HER2 IHC scoring.

Download

E-LEARNING

Topic 1: Clinical innovation across the HER2 pathway

Dr. Krishnamurthy presents the evolution of HER2 in clinical practice. (7 mins)

Play video

E-LEARNING

Topic 2: The spectrum of HER2 expression

Dr. Tozbikian reviews current HER2 guidelines and the significance of discrete HER2 IHC scoring. (9 mins)

Play video

E-LEARNING

Topic 3: Overcoming challenges in assessing HER2 expression across the spectrum

Dr. Hicks highlights best clinical practices for differentiating low levels of HER2. (11 mins)

Play video

GUIDE

HER2 expression in breast cancer: A comprehensive reference

A downloadable comprehensive guide to HER2 IHC scoring.

Download
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HER2, human epidermal growth factor receptor 2; IHC, immunohistochemistry; WSI, whole slide image.

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This website is intended to help healthcare professionals practicing in Malaysia. find and access scientifically balanced, evidence-based, and peer-led information and professional resources in support of HER2 IHC evaluation in breast cancer.

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