We have the same "weekend dilemma" with greater than 48 hour fixation for
breast tissue for Her-2. We send them to a huge reference lab that stated
exactly as Richard. They have found that 72 hours has little impact on
ER/PR/HER2 , however, we do request HER2 - FISH (instead of IHC) in these
cases. Furthermore, the ref lab said that some of the things that labs are
doing to avoid over fixation are worse (such as holding tissue in alcohol
for extended periods of time, etc) because that hasn't been validated.
Also, I spoke with the radiologists that perform the core needle bxs and
stereotactic and they try to avoid sched. them before a weekend or holiday.
The excisional bx performed in the OR usually already have ER/PR/HER2 on the
previous needle bx.
Jan
--------------------------------------------------
From: <histonet-requ...@lists.utsouthwestern.edu>
Sent: Friday, February 03, 2012 1:00 PM
To: <histonet@lists.utsouthwestern.edu>
Subject: Histonet Digest, Vol 99, Issue 5
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Today's Topics:
1. Re: Breast IHC testing (Richard Cartun)
2. AW: [Histonet] Breast IHC testing (Gudrun Lang)
3. Looking for Histology work in Phoenix AZ area (Jill Cox)
----------------------------------------------------------------------
Message: 1
Date: Fri, 03 Feb 2012 12:51:47 -0500
From: "Richard Cartun" <rcar...@harthosp.org>
Subject: Re: [Histonet] Breast IHC testing
To: "histonet@lists.utsouthwestern.edu"
<histonet@lists.utsouthwestern.edu>, "Gale Limron"
<ga...@unionhospital.org>
Message-ID: <4f2bd863.7400.007...@harthosp.org>
Content-Type: text/plain; charset=US-ASCII
Those are recommendations from the CAP. You can experiment and then
validate longer fixation times. Several papers have come out over the
past two years demonstrating little, if any, impact on immunoreactivity
for ER, PR, and HER2 when breast tissue has been fixed longer than 72
hours. In my opinion, minimizing cold ischemic time, making sure the
tissue does not dry out, and taking "thin" slices of tissue (2-3 mm) for
fixation and processing are probably more important than time in formalin.
Hopefully, ASCO and CAP will change their recommendations based on these
studies.
Richard
Richard W. Cartun, MS, PhD
Director, Histology & Immunopathology
Director, Biospecimen Collection Programs
Assistant Director, Anatomic Pathology
Hartford Hospital
80 Seymour Street
Hartford, CT 06102
(860) 545-1596 Office
(860) 545-2204 Fax
Gale Limron <ga...@unionhospital.org> 2/3/2012 10:24 AM >>>
I would like to know what other hospitals are doing with breast specimens
that are resected on Friday and are in formalin longer than the maximum
number of hours that CAP allows for ER/PR and HER2/neu testing. We are
running into this problem since we don't currently work Saturday hours.
Thank you!
Gale Limron CT,HT (ASCP)
Histology Supervisor
Union Hospital
659 Boulevard
Dover, Ohio 44622
330-343-3311 ext 2562
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Message: 2
Date: Fri, 3 Feb 2012 18:55:20 +0100
From: "Gudrun Lang" <gu.l...@gmx.at>
Subject: AW: [Histonet] Breast IHC testing
To: "'Kuhnla, Melissa'" <melissa.kuh...@chsli.org>
Cc: histonet@lists.utsouthwestern.edu
Message-ID: <8062f9a9a566440ea5ca5f05e00c9...@dielangs.at>
Content-Type: text/plain; charset="iso-8859-1"
Referring to Her2 FISH, we perform this assay also on tissue with longer
fixation. We found the protocol with "retrieval" in citratebuffer followed
by protease digestion reliable.
Also with SISH techniques I prefer long fixation more than underfixation.
Is there a chemical explanation, why the fluorochrome will fade after long
fixation?
Gudrun
-----Ursprüngliche Nachricht-----
Von: histonet-boun...@lists.utsouthwestern.edu
[mailto:histonet-boun...@lists.utsouthwestern.edu] Im Auftrag von Kuhnla,
Melissa
Gesendet: Freitag, 03. Februar 2012 18:32
An: Gale Limron; histonet@lists.utsouthwestern.edu
Betreff: RE: [Histonet] Breast IHC testing
Hi,
Keep in mind some of the responses I have seem so far are for just IHC.
I think there is some literature stating that over fixation affects FISH
less, but we perform FISH only and still stay under 48hrs. We use
Pathvysion probes and the package insert also recommends not exceeding
48 hours, as signals will fade.
We currently have a short step on the processor where tissue is held in
70% alcohol. We have certain specimen collection cut off times so
everything is fixed between 6 and 4 hours. Three day, holiday weekends
we have technologists come in on Saturday and embed everything.
Melissa :)
-----Original Message-----
From: histonet-boun...@lists.utsouthwestern.edu
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Gale
Limron
Sent: Friday, February 03, 2012 10:24 AM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] Breast IHC testing
I would like to know what other hospitals are doing with breast
specimens that are resected on Friday and are in formalin longer than
the maximum number of hours that CAP allows for ER/PR and HER2/neu
testing. We are running into this problem since we don't currently work
Saturday hours.
Thank you!
Gale Limron CT,HT (ASCP)
Histology Supervisor
Union Hospital
659 Boulevard
Dover, Ohio 44622
330-343-3311 ext 2562
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------------------------------
Message: 3
Date: Fri, 3 Feb 2012 09:58:33 -0800 (PST)
From: Jill Cox <jco...@yahoo.com>
Subject: [Histonet] Looking for Histology work in Phoenix AZ area
To: "Histonet@Lists. Edu" <histonet@lists.utsouthwestern.edu>
Message-ID:
<1328291913.82424.yahoomail...@web161601.mail.bf1.yahoo.com>
Content-Type: text/plain; charset=iso-8859-1
Hi all,
I am looking for Histology work in the Phoenix area. I am an HT and have
17 years experience with 6 years management. Looking for Full or Part
time.. Thanks!!
Jill Cox, HT ASCP
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