HER2

I was diagnosed with breast cancer in July.  I had an invasive ductal cell carcinoma.  I had a lumpectomy.  No cancer in lymph nodes.  Considered stage 1 but the cancer cell is a grade 3, estrogen and progesterone negative.  The HER2 testing has been done repeatedly and I come back as an "indeterminate".  My oncologist and surgeon feel I should be taking herceptin but the insurance company will not pay since I am not positive.  My oncologist says after 26 years he has never seen the repeated "indeterminate".  Is this unusual?

[Cleveland Clinic]

Dear daisbell:  There are two tests for HER2 neu overexpression.  One is immunohistochemistry and the other is FISH.  FISH is considered to be the more accurate of the two.  If one test comes back equivocal, typically the other test is done. Sometimes both will be equivocal in which case the treating physician needs to use his or her judgment and experience to determine the best treatment. Often when an insurance company declines something, an appeal or even a “doctor to doctor” discussion with the insurance company can result in a change in their decision.