Stains
HER2

Author: Nat Pernick, M.D. (see Authors page)

Revised: 1 August 2018, last major update December 2012

Copyright: (c) 2002-2018, PathologyOutlines.com, Inc.

PubMed Search: HER2 [title]

Cite this page: Pernick, N. HER2. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/stainsher2.html. Accessed November 12th, 2018.
Definition / general
  • Also called Human Epidermal growth factor Receptor 2, c-erbB2, neu, ERBB2 and CD340
  • HER2 gene encodes transmembrane glycoprotein (p185) with tyrosine kinase activity
  • Related to EGFR
  • May cross reactive with P glycoprotein / CD243
  • Receptor acts via homo or heterodimerization with other EGFR family receptors
  • In embryogenesis, helps establish several cell lineages through mesenchyme-epithelial-neuroectodermal inductive processes
  • Influences cellular migration, differentiation, and interactions between cells
  • DNA microarray profiling studies have divided invasive breast carcinoma into molecular subtypes:
    • Luminal A (ER+, HER2-)
    • Luminal B (ER+, HER2+)
    • HER2 positive (ER-, HER2+)
    • Normal breast-like (ER+, PR+, HER2-)
    • Basal-like (ER-, HER2-, EGFR+ or cytokeratin 5/6+)
Interpretation
Uses by pathologists
  • Breast cancer: confirm histologic classification (based on molecular classification), determine use of anti-HER2 therapies including Herceptin and Tykerb, negative prognostic factor
  • Gastric and gastroesophageal junction adenocarcinoma: determine use of anti-HER2 therapies (Arch Pathol Lab Med 2012;136:691), which improve survival in HER2+ patients
Microscopic (histologic) images

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Breast, neuroendocrine carcinoma, HER2-

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Breast, Paget disease



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Bladder,
carcinoma in situ,
full thickness
HER2+ staining

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Breast, apocrine carcinoma

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Breast, DCIS

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HER2 oncoprotein

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Breast, ductal carcinoma vs medullary


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Breast, Paget disease and underlying DCIS

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Esophagus, adenocarcinoma

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Stomach, gastric and gastroesophageal junction adenocarcinoma



Positive staining - disease
Negative staining
  • Breast myoepithelial and Toker cells
  • Breast: adenoid cystic carcinoma, lobular carcinoma, triple negative carcinomas [basal-like, medullary (Arch Pathol Lab Med 2003;127:1458), metaplastic, squamous]
  • Skin: Bowen disease
Molecular / cytogenetics images

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Breast, apocrine carcinoma - HER2+ by CISH

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Esophagus, adenocarcinoma