Immunohistochemical and molecular analyses of HER2 status in breast cancers are highly concordant and complementary approaches.

BACKGROUND: Immunohistochemistry (IHC) and fluorescent in situ hybridisation (FISH) are currently the most commonly used methods to assess HER2 status. PCR-based assays allow quantitative determination of HER2 amplification (Q-PCR) or overexpression (Q-RT-PCR), but are not routinely used. We evaluated the relevance of Q-RT-PCR for HER2 status determination. METHODS: We compared IHC and Q-RT-PCR in 466 breast tumours. In discordant or equivocal cases, five additional methods (IHC with two other antibodies, FISH, silver in situ hybridisation (SISH) and Q-PCR) were combined to determine HER2 status. Two cases with HER2 intra-tumour heterogeneity were further explored by allelic profiles analysis and HUMARA clonality determination after microdissection. RESULTS: We observed 97.3% concordance between Q-RT-PCR and non-equivocal IHC. Twelve out of 466 cases (3%) revealed discordances between the two methods. The power of Q-RT-PCR to predict HER2 status (defined by seven methods) was similar to that of IHC. Although rare, some discordances between techniques might be due to HER2 intra-tumour heterogeneity and we report two examples, one tumour containing two distinct clones, another tumour consisting of HER2 amplified and non-amplified subclones. CONCLUSION: Q-RT-PCR and IHC are highly concordant methods for HER2 status assessment, and Q-RT-PCR allows a highly reliable quantitative assessment and could be a useful adjunct to IHC.

[Radiation-induced sarcoma of the hip. Apropos of a case]. / Sarcome radio-induit de la hanche A propos d'un cas.

The authors describe a case of post radiation sarcoma of the hip, rare complication in the post radiation lesions. This case associates a post radiation coxopathy treated by total hip arthroplasty, a socket loosening with pelvic fracture, and a post radiation sarcoma. This last complication was fatal.

[Radiation lesions of the hip]. / Les radio-lésions de la hanche

Irradiation lesions of the hip are much better known than they used to be, and problems diagnosis no longer arise. Study of these 49 cases of irradiation lesions of the hip shows that they occur in 1 to 36 per cent of patients irradiated for pelvic cancer. The rate of occurrence may be reduced by selection and improvement in the techniques of radiotherapy. The extent of the lesions is determined from the time that irradiation is stopped. The lesions appear after a delay of several months and develop progressively throughout their extent. This confer on them a false appearance of a progressive lesion. There are severe lesions, which seriously threaten ambulation. Trans-cervical fractures should be considered separately; these are usually isolated lesions, simple to treat and of good prognosis. Fractures of the acetabulum and necroses of the acetabular roof or of the femoral head, developing usually as paired lesions or in the context of an irradiation coxopathy, constitute another group, in which treatment by total prosthesis raises numerous technical problems. Total prosthesis has however given to these hips; in almost 2 cases out of 3, a function which is at present satisfactory but whose future is unknown. The abnormality high levels of infection and in particular loosening are related to the extent to which the lesions have progressed. Resection of these prosthesis in cases of failure is similar to resection of the head and neck, and has its place as a salvage operation since its allows mobility and pain relief to be obtained at the price of stability.