DISH is crucial for precision therapy in breast cancer; significantly reducing the waiting period and subsequent delay in embarking on the right treatment plan
Cytelabs, specialised oncopathology cancer diagnostic service powered by Cytecare Cancer Hospital has officially announced the launch of Dual in situ hybridization (DISH) testing for breast cancer. This is increasingly getting popular as a preferred method of testing HER2 status in breast cancer.
Approved by the United States Food and Drug Administration (FDA), globally DISH is a helps in accurate human epidermal growth factor receptor 2 (HER2) testing, which is crucial for precision therapy in breast cancer. It significantly reduces the waiting period (HER2 status report within 24-48 hours) and angst among patients and their families.
Dr Aparna Gangoli, Director, Cytelabs, said, “DISH promises quality results and short turnaround time ensuring that the treatment for breast cancer can be planned and initiated without wasting undue time.The prognostic and predictive implications of HER2 status makes accurate and efficient HER2 testing of paramount importance in characterising all invasive breast carcinomas.”
Breast cancer cases are prognostically divided into HER2 positive and HER2 negative groups. HER2 positive patients can benefit from targeted therapy with Trastuzumab, a therapeutic agent which blocks the HER2 antigen sites on the HER2 expressing tumour cells and stops them from proliferating further.
Accurate HER2 testing is critical for determining the most suitable treatment for patients. First line of investigation for the HER2 positive tumour cells is by immuno histochemistry (IHC), which categorises the tumour cells into either HER2 positive, HER2 negative or HER2 equivocal. The HER2 equivocal category warrants further testing by an advanced technique to give the final HER2 status so that the right treatment can be embarked upon.
“Traditionally, these equivocal cases are subjected to Fluorescent in situ hybridization (FISH) technique for the final status. This testmandatorily requires fluorescent microscope and trained personnel, which is not easily available in all Indian hospitals dealing with cancer cases. Hence this necessitates outsourcing this test to a specialized centre either within the city or outside,” explains Dr Gangoli.
Furthermore, the test itself is time-consuming, invariably leading to a waiting period of a week to 12 days, depending on the work load and other variables. DISH, on the other hand, provides the final HER2 status report within 24-48 hours. What’s more, it is available at the same price point as FISH.
Unlike FISH though, DISH is interpreted through the usual binocular, non-fluorescent microscope on the same biopsy tissue, through a different technique. The slide preparation albeit is done on an automated platform, Ventana, in accordance with the standard guidelines. In addition, DISH also enables the pathologist to visualise and thereby select the individual tumour cells better, which is not possible in FISH.
Currently, Cytelabs provides access to cancer diagnostic services to oncologists and patients across 65 partner hospitals in Karnataka, Andhra Pradesh, and Telangana.