This activity is part of the Multidisciplinary Breast Pathology (MBP) learning series. Save 10% when you purchase all of the courses in this series together. Below are the courses included in the series. Click here to see all courses in the series.

• 2018 HER2 Focused Update
• Diagnosing and Classifying Hyperplasia, Atypical Hyperplasia and Low Grade DCIS
• Diagnosing Breast Lesions
• Getting Your Message Across: Effective Communication Strategies for Breast Pathologists
• Invasive Breast Cancer and Risk of Recurrence Testing
• Understanding Breast Imaging Terminology

Rereleased Activity
This activity was originally released as 2018 HER2 Focused Update and was available between July 1, 2020, and June 30, 2023. The content was reviewed in December 2022.

Description
In 2018, the American Society of Clinical Oncology and the College of American Pathologists developed a focused update on human epidermal growth factor receptor 2 (HER2) testing in breast cancer. The focused update endorses the 2013 HER2 testing guidelines while addressing outstanding questions related to HER2 testing. It focuses on specific clinical topics that have been raised by the clinical community and in the literature since the publication of the 2013 guidelines. This activity addresses each of the clinical questions and includes case studies that illustrate the practical application of what has been proposed in this update. After you complete the activity, you will be presented with a five-question assessment.

Objectives
After completing this activity, you should be able to:

1. Describe the purpose of the 2018 HER2 Focused Update.
2. State the most appropriate definition for IHC2+ (IHC equivocal).
3. Clarify if HER2 testing must be repeated on a surgical specimen if initially negative test on core biopsy.
4. Explain if invasive cancers with a HER2/chromosome enumeration probe 17 (CEP17) ratio of ≥2 but an average HER2 copy number of <4.0 signals per cell should be considered ISH positive.
5. Explain if invasive cancers with an average HER2 copy number of ≥6.0 signals per cell but a HER2/CEP17 ratio of <2.0 should be considered ISH positive.
6. Explain the appropriate diagnostic workup for invasive cancers with an average HER2 copy number ≥4.0 but <6.0 signals per cell and a HER2/CEP17 ratio <2.0 and initially deemed to have an equivocal HER2 ISH test result.

Authors/Faculty
David G. Hicks, MD, FCAP
Monisha Bhanote, MD, FCAP

CME Information
Accreditation: The College of American Pathologists (CAP) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

CME Category 1: The College of American Pathologists designates this internet enduring material educational activity for a maximum of 1.25 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Payment Information
To pay with a check, print a copy of this page and send it with your check to the address below. You will be notified when your payment has been processed and you have been registered into the activity.

College of American Pathologists
CAP Learning
325 Waukegan Road
Northfield, IL 60093-2750

Refund Policy
Refunds will be handled on an exception basis. Please submit your request to the CAP in writing via email at education@cap.org or fax at 847-832-8006.

Technical Requirements
Pop-up blockers must be turned off.

The CAP recognizes that some Veteran’s Administration, US Government, and military participants may have difficulty accessing the online activity. If you experience difficulty or have any questions, please contact a representative of the Customer Contact Center at 800-323-4040 option 1 or education@cap.org.

Availability
This activity and evaluation are available June 29, 2023, and expire June 29, 2026, at 11:59 PM (CT). Upon completion of the activity your credit will be awarded. Your certificate may be downloaded from your Transcript.

CC: MBPHER206W.2023