(HealthDay News) — Human epidermal growth factor receptor 2 (HER2) status should be determined in all patients with invasive breast cancer, according to updated clinical practice guidelines published online Oct. 7 in the Journal of Clinical Oncology.

Antonio C. Wolff, M.D., from the Johns Hopkins Kimmel Comprehensive Cancer Center in Baltimore, and colleagues from the American Society of Clinical Oncology/College of American Pathologists (CAP) conducted a systematic literature review and updated recommendations for optimal HER2 testing.

The authors recommend determining HER2 status in all patients with invasive breast cancer, on the basis of one or more HER2 test results. HER2 positive status is defined as evidence of protein overexpression (by immunohistochemistry testing) or gene amplification (by in situ hybridization testing). Reflex testing using an alternative assay should be performed if results are equivocal. If results seem discordant with other histopathologic findings, repeat testing should be considered. Testing should be performed in CAP- or another accrediting entity-accredited laboratories. To ensure the highest quality testing, providers and health systems are urged to cooperate.

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“Awareness of possible disparities in access to care should be considered in the context of this clinical practice guideline, and health care providers should strive to deliver the highest level of cancer care to these vulnerable populations,” the authors write.

Several authors disclosed financial ties to the pharmaceutical industry.

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