[Histonet] Re:Breast IHC testing

Fri Feb 3 19:45:30 CST 2012

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

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Sent: Friday, February 03, 2012 1:00 PM
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Subject: Histonet Digest, Vol 99, Issue 5

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> Today's Topics:
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>   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)
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> ----------------------------------------------------------------------
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> Message: 1
> Date: Fri, 03 Feb 2012 12:51:47 -0500
> From: "Richard Cartun" <Rcartun <@t> harthosp.org>
> Subject: Re: [Histonet] Breast IHC testing
> To: "histonet <@t> lists.utsouthwestern.edu"
> <histonet <@t> lists.utsouthwestern.edu>, "Gale Limron"
> <GaleL <@t> unionhospital.org>
> Message-ID: <4F2BD863.7400.0077.1 <@t> harthosp.org>
> Content-Type: text/plain; charset=US-ASCII
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> 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 <GaleL <@t> 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.lang <@t> gmx.at>
> Subject: AW: [Histonet] Breast IHC testing
> To: "'Kuhnla, Melissa'" <Melissa.Kuhnla <@t> chsli.org>
> Cc: histonet <@t> lists.utsouthwestern.edu
> Message-ID: <8062F9A9A566440EA5CA5F05E00C983C <@t> 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-bounces <@t> lists.utsouthwestern.edu
> [mailto:histonet-bounces <@t> lists.utsouthwestern.edu] Im Auftrag von Kuhnla,
> Melissa
> Gesendet: Freitag, 03. Februar 2012 18:32
> An: Gale Limron; histonet <@t> 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-bounces <@t> lists.utsouthwestern.edu
> [mailto:histonet-bounces <@t> lists.utsouthwestern.edu] On Behalf Of Gale
> Limron
> Sent: Friday, February 03, 2012 10:24 AM
> To: histonet <@t> 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 <jcox90 <@t> yahoo.com>
> Subject: [Histonet] Looking for Histology work in Phoenix AZ area
> To: "Histonet <@t> Lists. Edu" <histonet <@t> lists.utsouthwestern.edu>
> Message-ID:
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> 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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> End of Histonet Digest, Vol 99, Issue 5
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