The updated ASCO/CAP guideline recommendations for HER2 testing in the management of invasive breast cancer: critical review of their implications for routine practice.

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Abstract

The American Society of Clinical Oncology (ASCO) and the College of American Pathologists (CAP) have issued a joint updated comprehensive guideline recommendations for HER2 testing in breast cancer. The current update not only provides guideline of the test performance parameters that aims to improve test accuracy, reproducibility and precision but also provides comprehensive recommendation on the post-analytical interpretation of the results and requires improved communication among health care providers. The update guideline is targeting testing laboratories and pathologists, oncologists, surgeons and indirectly other health care providers. Although the guidelines contribute to improved analytical validity and clinical utility of laboratory assays required for successful molecularly targeted therapy in the era of personalised medicine, implications for such recommendations have to be acknowledged. Certain recommendations particularly those related to repeating the test and pathological concordance have limited levels of supportive evidence than for existing key recommendations and the workload implications associated will be challenging to support in most healthcare systems. In this commentary we critically address the key updated recommendations and their impact on service provision and patients care. This article is protected by copyright. All rights reserved.