Fellow Histonet Subscribers,
I have been noticing a LOT of misinformation being passed around this site, much coming from one respondent in particular. This is very troubling, as our position in healthcare, and the work we do, is so very critical to patient care and patient outcomes. I would hope that before responding to questions, people either know what they are talking about, or make it clear that it is opinion they are expressing, and not necessarily fact. Perhaps including some reference, or web link to information is practical at times. Here I have listed below responses to some questions that are outright false, and the information presented, if followed, in some instances may put a lab in jeopardy when inspected. It also appears that we have techs from marine biology centers, and plant histology labs answering questions pertaining to medicine. I am not sure how appropriate that is. This is, of course, just my opinion. *In Response to the question of where to store blocks this was an answer:* “Both but especially the place where the diagnosis takes place.” It is not possible to store blocks in BOTH locations. Why would you do that? And “especially the place where the diagnosis takes place” is incorrect. The logical place to keep the blocks is where the histology is performed. If space does not permit long term storage, rent a facility that is compliant with your state requirements for doing so. As far as time to keep blocks, CLIA and CAP have different requirements. Check with your State to see if they are even more stringent than CAP. Here is what CLIA, and CAP require: FROM CLIA: Sec. 493.1105 Standard: Retention requirements (a)(3)(ii) Blocks. Retain pathology specimen blocks for at least 2 years from the date of examination. FROM CAP: Retention of Laboratory Records and Materials: *Surgical Pathology (including bone marrows)* Wet tissue 2 weeks after final report Paraffin blocks 10 years Slides 10 years Reports 10 years *In Response to Water Quality this response was noted:* “No "small laboratory" has the conditions required to perform microbiology cultures” This is an inaccurate statement. Size of a lab, and ability to perform work in a sterile environment are not at all related. When responding to questions as important as breast fixation times, it would be helpful to include information like what I included immediately below – furthermore, as all of you know, breast tissue fixes differently depending upon several factors, especially fat content, and thickness of the sections. The question of best fixation time is not an answerable question – it is specific to the case itself. Is it cores we are talking about? Is it a dense fibrous lumpectomy? Is it a fatty mastectomy? There is no perfect answer to that question. *What are the changes made to minimum fixation times?* The minimum fixation time for HER2 has been clarified and we recommend that samples for HER2 testing be fixed a minimum of 6 hours. The original statement that smaller samples can be fixed for less than 6 hours is not supported by the literature. We recommend that sample for HER2 testing be fixed a minimum of 6 hours regardless of sample size. *WWhat about changes to maximum fixation times? The HER2 fixation time of 6-48 hours is not consistent with that of the ER/PgR fixation time of 6-72 hours.* We are unable to find evidence to support increasing the HER2 fixation time and therefore recommendations for fixation times in neutral buffered formalin are unchanged (6-48 hours for HER2 and 6-72 hours for ER/PgR). The data about the stability of ER and PgR at intervals of 48-72 hours suggest that changing this interval for HER2 testing will not result in adverse testing results. However, there is a lack of specific published studies for HER2 IHC that included specimens with low levels of HER2 expression that would be more vulnerable to fixation time changes. *What are the changes made to minimum fixation times?* The minimum fixation time for HER2 has been clarified and we recommend that samples for HER2 testing be fixed a minimum of 6 hours. The original statement that smaller samples can be fixed for less than 6 hours is not supported by the literature. We recommend that sample for HER2 testing be fixed a minimum of 6 hours regardless of sample size. On Wed, Mar 21, 2012 at 1:27 PM, Rene J Buesa <rjbu...@yahoo.com> wrote: > Both but especially the place where the diagnosis takes place. > René J. > > --- On Wed, 3/21/12, Cynthia Pyse <cp...@x-celllab.com> wrote: > > > From: Cynthia Pyse <cp...@x-celllab.com> > Subject: RE: [Histonet] Block Storage-another question > To: "'Rene J Buesa'" <rjbu...@yahoo.com>, "'Ann Angelo'" < > thisis...@aol.com>, histonet@lists.utsouthwestern.edu, "'FeltonNails'" < > flna...@texaschildrens.org> > Date: Wednesday, March 21, 2012, 11:25 AM > > > If the pod lab is in NJ and the "reading" lab is in NY, which guide lines > do > you follow. NYS requires us to save our blocks for 20 years. Due to storage > issues, I would rather the pod lab store the blocks. > Cindy > > -----Original Message----- > From: histonet-boun...@lists.utsouthwestern.edu > [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Rene J > Buesa > Sent: Wednesday, March 21, 2012 10:20 AM > To: 'Ann Angelo'; histonet@lists.utsouthwestern.edu; FeltonNails > Subject: RE: [Histonet] Block Storage > > Depending on the state regulations and the laboratory policies,blocks are > stored during different periods of time before being discarded. I used to > store them for 9 years. > René J. > > --- On Wed, 3/21/12, Nails, Felton <flna...@texaschildrens.org> wrote: > > > From: Nails, Felton <flna...@texaschildrens.org> > Subject: RE: [Histonet] Block Storage > To: "'Ann Angelo'" <thisis...@aol.com>, "histonet@lists.utsouthwestern.edu > " > <histonet@lists.utsouthwestern.edu> > Date: Wednesday, March 21, 2012, 9:00 AM > > > This is a very sticky issue, when I setup inhouse labs I always present the > argument that during inspections the lab that produces a report should have > access to all test material which includes blocks and slides per the CAP > checklist. > Ann trying approaching it from that angle. > > -----Original Message----- > From: histonet-boun...@lists.utsouthwestern.edu > [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Ann Angelo > Sent: Tuesday, March 20, 2012 6:58 PM > To: histonet@lists.utsouthwestern.edu > Subject: [Histonet] Block Storage > > Does anyone know if a laboratory in NJ is required to keep the blocks they > perform Technical component on if they do not perform the professional > component....or should they have the facility performing the professional > component store them? Who is ultimately responsible? Ann > _______________________________________________ > Histonet mailing list > Histonet@lists.utsouthwestern.edu > http://lists.utsouthwestern.edu/mailman/listinfo/histonet > > ______________________________________________________________________ > CONFIDENTIALITY NOTICE: > The information in this e-mail may be confidential and/or > privileged. If you are not the intended recipient or an > authorized representative of the intended recipient, you > are hereby notified that any review, dissemination, or > copying of this e-mail and its attachments, if any, or > the information contained herein is prohibited. If you > have received this e-mail in error, please immediately > notify the sender by return e-mail and delete this e-mail > from your computer system. Thank you. > ______________________________________________________________________ > > _______________________________________________ > Histonet mailing list > Histonet@lists.utsouthwestern.edu > http://lists.utsouthwestern.edu/mailman/listinfo/histonet > _______________________________________________ > Histonet mailing list > Histonet@lists.utsouthwestern.edu > http://lists.utsouthwestern.edu/mailman/listinfo/histonet > > > > _______________________________________________ > Histonet mailing list > Histonet@lists.utsouthwestern.edu > http://lists.utsouthwestern.edu/mailman/listinfo/histonet > -- *David Costanzo, MHS, PA (ASCP)* Project Manager *Blufrog Path Lab Solutions* 9401 Wilshire Blvd. Ste 650 Beverly Hills, CA 90212 _______________________________________________ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet