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 completing this SAM eligible activity and posttest, you should be able to:
- Describe the purpose of the 2018 HER2 Focused Update.
- State the most appropriate definition for IHC2+ (IHC equivocal).
- Clarify if HER2 testing must be repeated on a surgical specimen if initially negative test on core biopsy.
- 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.
- 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.
- 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.
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.
This activity meets the American Board of Pathology’s (ABPath) Maintenance of Certification (MOC) requirements for Self-Assessment Modules (SAMs).
Continuing Professional Development (CPD), Section 3 Credit
Accreditation in Canada: This event is an Accredited Self Assessment Program (Section 3) as defined by the Maintenance of Certification Program of the Royal College of Physicians and Surgeons of Canada, approved by the Canadian Association of Pathologists - Association Canadienne des Pathologistes. You may claim a maximum of 1.25 hour(s) equivalent to 3.75 credit(s).
You have a total of three opportunities to take and pass the posttest. If you correctly answer 70% or more of the posttest items, you may claim credit. CME/SAM credit can be applied to the American Board of Pathology (ABPath) Self-Assessment Module (SAM) requirements.You must pass the posttest to claim credit; therefore, if you do not pass, you cannot claim any credit.
Attention Canadian Participants: You have three opportunities to take and pass the posttest. If you do not pass the posttest after three attempts, you may still claim CPD credit (self-assessment program credits) for this activity. Please contact a representative of the CAP Learning Division at 800-323-4040 option 1 or email@example.com with the name of this activity and the date completed to request a letter of participation.
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
325 Waukegan Road
Northfield, IL 60093-2750
Refunds will be handled on an exception basis. Please submit your request to the CAP in writing via email at
firstname.lastname@example.org or fax at 847-832-8006.
Pop-up blockers must be turned off.
CAP Learning has recognized that some Veteran’s Administration, US Government, and military participants may have difficulty accessing the online assessment portion of this activity. If you experience difficulty or have any questions, please contact a representative of the CAP Learning Division at 800-323-4040 option 1 or email@example.com.
This activity and evaluation are available July 1, 2020, and expire June 30, 2023, at 12:00 AM (ET). You MUST claim credit by this date and time.