RE: [Histonet] Her2 Fixation Requirement
We adhere the ink with bouins sol'n. Have had no problems. Kim Donadio Pathology Supervisor Baptist Hospital 1000 W Moreno St. Pensacola FL 32501 Phone (850) 469-7718 Fax (850) 434-4996 Rathborne, Toni trathbo...@somerset-healthcare.com Sent by: histonet-boun...@lists.utsouthwestern.edu 02/03/2011 04:54 PM To Weems, Joyce jwe...@sjha.org, Paula Lucas plu...@biopath.org, histonet@lists.utsouthwestern.edu cc Subject RE: [Histonet] Her2 Fixation Requirement Does anyone have issues with inking the specimen after it has been placed in formalin? -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu]On Behalf Of Weems, Joyce Sent: Wednesday, February 02, 2011 12:59 PM To: Paula Lucas; histonet@lists.utsouthwestern.edu Subject: RE: [Histonet] Her2 Fixation Requirement We have the nurse document the time of removal on the requisition. The next requisition update will have a spot for this. They have been very cooperative and do a good job. In addition, you must document the cold ischmic time - that is the time from removal until time in formalin. This is important when the specimen goes for xray or whatever. So there is a removal time, an into formalin time and an out of formalin time. Then if we don't have time allowed to meet the fixation time with the regular, it is put on a late processor, if we have one available, or it is held overnight. And if it has to come off on Sunday, we have a med tech remove it from the processor and it waits for us to come on Monday to embed it. The pathologists document all this time in the report. Best! J Joyce Weems Pathology Manager Saint Joseph's Hospital 5665 Peachtree Dunwoody Rd NE Atlanta, GA 30342 678-843-7376 - Phone 678-843-7831 - Fax -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Paula Lucas Sent: Wednesday, February 02, 2011 12:11 To: histonet@lists.utsouthwestern.edu Subject: [Histonet] Her2 Fixation Requirement Hello histoland I was just given the task to find a solution that is easy and will also comply with the CAP guideline for formalin fixation documentation, and so I started my research on the Histonet archives. I found some good information, but was hoping to get more feedback. Would you mind sharing with me the actions you are taking to comply with the guideline? We are a private lab and we provide histology/pathology service for 2 hospitals and a few surgery centers. We send our blocks to Genzyme for Her2, and we must document on their test order sheet how many hours the tissues have been fixed in formalin. I'm assuming I will need to start keeping a log here, with documentation that shows what time the tissue was excised and placed in formalin from the OR, and then documentation that shows the time it was dissected and then placed in the tissue processor. The problem that I may come across is getting the OR nurse to document the time for us. I don't know...maybe we need to put another sections on our requisition form, or maybe something on the formalin container itself for the nurse to write on. It'll be a hassle at first but if I can get the hospitals lab director involved, I'm sure it will work itself out. Anyway, if you wouldn't mind sharing some of your ideas, I would really appreciate it. Paula Lucas Lab Manager Bio-Path Medical Group Fountain Valley, CA ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet Confidentiality Notice: This e-mail, including any attachments is the property of Catholic Health East and is intended for the sole use of the intended recipient(s). It may contain information that is privileged and confidential. Any unauthorized review, use, disclosure, or distribution is prohibited. If you are not the intended recipient, please delete this message, and reply to the sender regarding the error in a separate email. ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet CONFIDENTIALITY NOTICE This message and any included attachments are from Somerset Medical Center and are intended only for the addressee. The information contained in this message is confidential and may contain privileged, confidential, proprietary and/or trade secret information entitled to protection and/or exemption from disclosure under applicable law. Unauthorized forwarding, printing, copying, distribution, or use of such information is strictly prohibited and may be unlawful. If you are not the addressee, please promptly delete this message and notify the sender of the delivery error by e-mail or you may call Somerset Medical Center's computer Help Desk at 908-685-2200, ext
RE: [Histonet] Her2 Fixation Requirement
Does anyone have issues with inking the specimen after it has been placed in formalin? -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu]On Behalf Of Weems, Joyce Sent: Wednesday, February 02, 2011 12:59 PM To: Paula Lucas; histonet@lists.utsouthwestern.edu Subject: RE: [Histonet] Her2 Fixation Requirement We have the nurse document the time of removal on the requisition. The next requisition update will have a spot for this. They have been very cooperative and do a good job. In addition, you must document the cold ischmic time - that is the time from removal until time in formalin. This is important when the specimen goes for xray or whatever. So there is a removal time, an into formalin time and an out of formalin time. Then if we don't have time allowed to meet the fixation time with the regular, it is put on a late processor, if we have one available, or it is held overnight. And if it has to come off on Sunday, we have a med tech remove it from the processor and it waits for us to come on Monday to embed it. The pathologists document all this time in the report. Best! J Joyce Weems Pathology Manager Saint Joseph's Hospital 5665 Peachtree Dunwoody Rd NE Atlanta, GA 30342 678-843-7376 - Phone 678-843-7831 - Fax -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Paula Lucas Sent: Wednesday, February 02, 2011 12:11 To: histonet@lists.utsouthwestern.edu Subject: [Histonet] Her2 Fixation Requirement Hello histoland I was just given the task to find a solution that is easy and will also comply with the CAP guideline for formalin fixation documentation, and so I started my research on the Histonet archives. I found some good information, but was hoping to get more feedback. Would you mind sharing with me the actions you are taking to comply with the guideline? We are a private lab and we provide histology/pathology service for 2 hospitals and a few surgery centers. We send our blocks to Genzyme for Her2, and we must document on their test order sheet how many hours the tissues have been fixed in formalin. I'm assuming I will need to start keeping a log here, with documentation that shows what time the tissue was excised and placed in formalin from the OR, and then documentation that shows the time it was dissected and then placed in the tissue processor. The problem that I may come across is getting the OR nurse to document the time for us. I don't know...maybe we need to put another sections on our requisition form, or maybe something on the formalin container itself for the nurse to write on. It'll be a hassle at first but if I can get the hospitals lab director involved, I'm sure it will work itself out. Anyway, if you wouldn't mind sharing some of your ideas, I would really appreciate it. Paula Lucas Lab Manager Bio-Path Medical Group Fountain Valley, CA ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet Confidentiality Notice: This e-mail, including any attachments is the property of Catholic Health East and is intended for the sole use of the intended recipient(s). It may contain information that is privileged and confidential. Any unauthorized review, use, disclosure, or distribution is prohibited. If you are not the intended recipient, please delete this message, and reply to the sender regarding the error in a separate email. ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet CONFIDENTIALITY NOTICE This message and any included attachments are from Somerset Medical Center and are intended only for the addressee. The information contained in this message is confidential and may contain privileged, confidential, proprietary and/or trade secret information entitled to protection and/or exemption from disclosure under applicable law. Unauthorized forwarding, printing, copying, distribution, or use of such information is strictly prohibited and may be unlawful. If you are not the addressee, please promptly delete this message and notify the sender of the delivery error by e-mail or you may call Somerset Medical Center's computer Help Desk at 908-685-2200, ext. 4050. Be sure to visit Somerset Medical Center's Web site - www.somersetmedicalcenter.com - for the most up-to-date news, event listings, health information and more. ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
Re: [Histonet] Her2 Fixation Requirement
We receive our lumpectomies and total breasts fresh. They are immediately put in 10 % formalin if no frozen is required and that time is noted on our requisition. Our processing time for formalin and the fixation time is made part of the final report. If we receive a breast biopsy specimen we have asked that they write the time on the requistion that the specimen was placed in 10 % formalin. We set up a procedure that states this. Beatrice Sullivan, HT(A.S.C.P.) HTL , AAS, CLSP(N.C.A.) AP Supervisor Shore Memorial Hospital 609-653-3590 Speak only well of people and you need never whisper Paula Lucas plucas@biopath.o rgTo Sent by: histonet@lists.utsouthwestern.edu histonet-bounces@ cc lists.utsouthwest ern.edu Subject [Histonet] Her2 Fixation Requirement 02/02/2011 12:11 PM Hello histoland I was just given the task to find a solution that is easy and will also comply with the CAP guideline for formalin fixation documentation, and so I started my research on the Histonet archives. I found some good information, but was hoping to get more feedback. Would you mind sharing with me the actions you are taking to comply with the guideline? We are a private lab and we provide histology/pathology service for 2 hospitals and a few surgery centers. We send our blocks to Genzyme for Her2, and we must document on their test order sheet how many hours the tissues have been fixed in formalin. I'm assuming I will need to start keeping a log here, with documentation that shows what time the tissue was excised and placed in formalin from the OR, and then documentation that shows the time it was dissected and then placed in the tissue processor. The problem that I may come across is getting the OR nurse to document the time for us. I don't know...maybe we need to put another sections on our requisition form, or maybe something on the formalin container itself for the nurse to write on. It'll be a hassle at first but if I can get the hospitals lab director involved, I'm sure it will work itself out. Anyway, if you wouldn't mind sharing some of your ideas, I would really appreciate it. Paula Lucas Lab Manager Bio-Path Medical Group Fountain Valley, CA ___ 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
RE: [Histonet] Her2 Fixation Requirement
We have the nurse document the time of removal on the requisition. The next requisition update will have a spot for this. They have been very cooperative and do a good job. In addition, you must document the cold ischmic time - that is the time from removal until time in formalin. This is important when the specimen goes for xray or whatever. So there is a removal time, an into formalin time and an out of formalin time. Then if we don't have time allowed to meet the fixation time with the regular, it is put on a late processor, if we have one available, or it is held overnight. And if it has to come off on Sunday, we have a med tech remove it from the processor and it waits for us to come on Monday to embed it. The pathologists document all this time in the report. Best! J Joyce Weems Pathology Manager Saint Joseph's Hospital 5665 Peachtree Dunwoody Rd NE Atlanta, GA 30342 678-843-7376 - Phone 678-843-7831 - Fax -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Paula Lucas Sent: Wednesday, February 02, 2011 12:11 To: histonet@lists.utsouthwestern.edu Subject: [Histonet] Her2 Fixation Requirement Hello histoland I was just given the task to find a solution that is easy and will also comply with the CAP guideline for formalin fixation documentation, and so I started my research on the Histonet archives. I found some good information, but was hoping to get more feedback. Would you mind sharing with me the actions you are taking to comply with the guideline? We are a private lab and we provide histology/pathology service for 2 hospitals and a few surgery centers. We send our blocks to Genzyme for Her2, and we must document on their test order sheet how many hours the tissues have been fixed in formalin. I'm assuming I will need to start keeping a log here, with documentation that shows what time the tissue was excised and placed in formalin from the OR, and then documentation that shows the time it was dissected and then placed in the tissue processor. The problem that I may come across is getting the OR nurse to document the time for us. I don't know...maybe we need to put another sections on our requisition form, or maybe something on the formalin container itself for the nurse to write on. It'll be a hassle at first but if I can get the hospitals lab director involved, I'm sure it will work itself out. Anyway, if you wouldn't mind sharing some of your ideas, I would really appreciate it. Paula Lucas Lab Manager Bio-Path Medical Group Fountain Valley, CA ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet Confidentiality Notice: This e-mail, including any attachments is the property of Catholic Health East and is intended for the sole use of the intended recipient(s). It may contain information that is privileged and confidential. Any unauthorized review, use, disclosure, or distribution is prohibited. If you are not the intended recipient, please delete this message, and reply to the sender regarding the error in a separate email. ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
RE: [Histonet] Her2 Fixation Requirement
What is the appropriate time it should be in formalin? Do you start your time when it is initially put into formalin, or the start from the time it was dissected? Lori A Disher Fawcett Memorial Hospital Port Charlotte, FL 33952 lori.dis...@hcahealthcare.com ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
RE: [Histonet] Her2 Fixation Requirement
Lori I would think both if you could since the Her2 paper does address those issues as potentials for problems in testing variation (time to fixation). I believe the CAP/ASCO paper states not less then 6 and no more than 48 hours for fixation (2007 paper). I believe you also should document type of fixative if possible; vendor, lot number and expiration date if you can. I have pdfs of these documents if you need them. Liz Elizabeth A. Chlipala, BS, HTL(ASCP)QIHC Manager Premier Laboratory, LLC PO Box 18592 Boulder, Colorado 80308 office (303) 682-3949 fax (303) 682-9060 www.premierlab.com Ship to Address: 1567 Skyway Drive, Unit E Longmont, Colorado 80504 -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of lori.dis...@hcahealthcare.com Sent: Wednesday, February 02, 2011 12:16 PM To: histonet@lists.utsouthwestern.edu Subject: RE: [Histonet] Her2 Fixation Requirement What is the appropriate time it should be in formalin? Do you start your time when it is initially put into formalin, or the start from the time it was dissected? Lori A Disher Fawcett Memorial Hospital Port Charlotte, FL 33952 lori.dis...@hcahealthcare.com ___ 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
RE: RE: [Histonet] Her2 Fixation Requirement
Formalin time is no less than 6 and no more than 48 hours. You need to document time from excision to time in formalin - cold ischemic time - and time in formalin. New regs extended fixation time for ER/PR to 72 hours, but since it's all in there together, you can't go by that yet. And for patient's to be eligible for many clinical trials, 10% NBF is the only fixative that should be used. j -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of lori.dis...@hcahealthcare.com Sent: Wednesday, February 02, 2011 14:16 To: histonet@lists.utsouthwestern.edu Subject: RE: [Histonet] Her2 Fixation Requirement What is the appropriate time it should be in formalin? Do you start your time when it is initially put into formalin, or the start from the time it was dissected? Lori A Disher Fawcett Memorial Hospital Port Charlotte, FL 33952 lori.dis...@hcahealthcare.com ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet Confidentiality Notice: This e-mail, including any attachments is the property of Catholic Health East and is intended for the sole use of the intended recipient(s). It may contain information that is privileged and confidential. Any unauthorized review, use, disclosure, or distribution is prohibited. If you are not the intended recipient, please delete this message, and reply to the sender regarding the error in a separate email. ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
RE: [Histonet] Her2 Fixation Requirement
I believe the two most recent articles from ASCO/CAP on this subject are Hammond, M.E., D.F. Hayes, M. Dowsett, D.C. Allred, K.L. Hagerty, S. Badve, P.L. Fitzgibbons, G. Francis, et al. 2010. American Society of Clinical Oncology/College Of American Pathologists guideline recommendations for immunohistochemical testing of estrogen and progesterone receptors in breast cancer. J Clin Oncol 28:2784-2795. Wolff, A.C., M.E. Hammond, J.N. Schwartz, K.L. Hagerty, D.C. Allred, R.J. Cote, M. Dowsett, P.L. Fitzgibbons, et al. 2007. American Society of Clinical Oncology/College of American Pathologists guideline recommendations for human epidermal growth factor receptor 2 testing in breast cancer. J Clin Oncol 25:118-145. If you do not have access to the literature you can request reprints from the authors or it may be available on the ASCO website? Luis -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Liz Chlipala Sent: Wednesday, February 02, 2011 2:28 PM To: lori.dis...@hcahealthcare.com; histonet@lists.utsouthwestern.edu Subject: RE: [Histonet] Her2 Fixation Requirement Lori I would think both if you could since the Her2 paper does address those issues as potentials for problems in testing variation (time to fixation). I believe the CAP/ASCO paper states not less then 6 and no more than 48 hours for fixation (2007 paper). I believe you also should document type of fixative if possible; vendor, lot number and expiration date if you can. I have pdfs of these documents if you need them. Liz Elizabeth A. Chlipala, BS, HTL(ASCP)QIHC Manager Premier Laboratory, LLC PO Box 18592 Boulder, Colorado 80308 office (303) 682-3949 fax (303) 682-9060 www.premierlab.com Ship to Address: 1567 Skyway Drive, Unit E Longmont, Colorado 80504 -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of lori.dis...@hcahealthcare.com Sent: Wednesday, February 02, 2011 12:16 PM To: histonet@lists.utsouthwestern.edu Subject: RE: [Histonet] Her2 Fixation Requirement What is the appropriate time it should be in formalin? Do you start your time when it is initially put into formalin, or the start from the time it was dissected? Lori A Disher Fawcett Memorial Hospital Port Charlotte, FL 33952 lori.dis...@hcahealthcare.com ___ 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 This email message, including any attachments, is for the sole use of the intended recipient(s) and may contain information that is proprietary, confidential, and exempt from disclosure under applicable law. Any unauthorized review, use, disclosure, or distribution is prohibited. If you have received this email in error please notify the sender by return email and delete the original message. Please note, the recipient should check this email and any attachments for the presence of viruses. The organization accepts no liability for any damage caused by any virus transmitted by this email. = ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
