Pathology laboratories planning to implement fluorescence in situ hybridization (FISH) for analysis of HER2 gene amplification in either the confirmatory setting as reflexed from immunohistochemistry or for primary testing of breast carcinomas, may encounter obstacles such as the requirement for specialized instrumentation for staining, supplemental training requirements for pathologists and technologists, delays attributable to overnight hybridization, and complex manual protocols. Silver in situ hybridization (SISH) as an alternative to FISH has been developed by Ventana Medical Systems.   more »