Understanding current attitudes in HER2 testing for breast cancer at tertiary referral hospitals of Metro Manila, Philippines

INTRODUCTION: The difficulty of obtaining accurate and reproducible assessment of HER2 status in the Philippines, despite the predictive value of the test for HER2 positive breast cancer patients, may be sufficiently addressed if an effective multidisciplinary approach to HER2 testing is carried out. This may be accomplished by identifying disparities and similarities in HER2 testing for breast cancer.METHODS: This is a cross-sectional study which included medical oncologists who had used trastuzumab for HER2-positive patients. Surgeons, who belonged to the same tertiary hospital as the medical oncologists were also interviewed. The survey questionnaires were administered via face-to-face, mail, or fax. Responses were kept confidential. Questionnaire responses were analysed using summary statistics.RESULTS: There were 35 medical oncologists and 37 surgeons - 93% stated that all women diagnosed with breast cancer should be tested for HER2 at the point of diagnosis; 61% stated that the greatest barrier to initiating HER2 testing was inadequate patient funds. 57% medical oncologists and 65% surgeons believed that HER2 testing for all breast cancer patients at the point of clinical diagnosis was being observed at their hospital. 69% stated that medical oncologists or surgeons should request for HER2 test whoever saw the patients first; 59% stated that whoever saw the patient first provide the patient information about HER2 testing whereas 28% stated it is the medical oncologist who should provide information about HER2 testing. 47% medical oncologist and 63% surgeons stated that surgeons should arrange for breast tissue sample collection; 27% medical oncologists and 20% surgeons stated that pathologists should do this.CONCLUSION: Medical oncologists and surgeons were similar in the opinion that all women diagnosed with breast cancer should be tested for HER2 at the point of diagnosis, financial capability was the greatest barrier for initiating HER2 testing, and whoever saw the patient first should provide patient education. There was disparity on who should request and who should arrange for tissue collection.

Specimen handling and tissue preaparation in pre-analytical phase of HER2 testing at tertiary referral hospitals of Metro Manila

INTRODUCTION: HER2 test result depends on a good quality histological section of the breast specimen. Laboratories that process specimens using sophisticated and molecular testing should receive suitable specimen for more accurate results and less waste of expensive resources.METHODS: A questionnaire based on the ASCO-CAP Guidelines for HER2 testing was developed and administered to pathologists from the local laboratories of Metro Manila-Philippines tertiary referral hospitals. Questionnaire responses were analyzed using descriptive statistics.RESULTS: Most laboratories did quality control/quality assessment monitoring for the pre-analytic, analytic,post-analytic and turn¬around time phases. Many transported their specimens from the operating room to the laboratoryCONCLUSION: Even in standardized procedures, small variations in sample processing for IHC and FISH can still occur. Inexperienced laboratories will have greater problems interpreting HER2 status results. Laboratories should look into their system in handling specimens for an accurate HER2 testing towards quality assurance.

Histological pattern and outcome of Filipino children with liver disease who underwent percutaneous liver biopsy: A five year survey

BACKGROUND: Histological assessment is important in evaluating liver disease. We determined the clinical diagnose and predominant histological patterns of children with liver disease and association of histological pattern with outcome. METHODS: Consecutive patients RESULT: 470 cases (1month-18years; 65% males; 85% CONCLUSION: Most common clinical diagnoses were neonatal hepatitis and biliary atresia. Predominant histological patterns were giant cell and obstructive type. Histological patterns of giant cell hepatitis seen in neonatal hepatitis resulted in better outcome.