[Histonet] RE: New Cap Guidelines for Her2 and ER/PR

Wed Oct 13 11:42:16 CDT 2010

All,

I've been watching this thread for a couple of days now and would like all
to know that had they attended workshop 17, provided they were in Seattle,
it would have been most insightful regarding all these guidelines. It was
titled "Quality Biospecimens for Personalized Molecular Healthacare" It
addressed fixation as well as cold ischemia time. Dr. Robb also commented
that as a governor for CAP,there will be CAP guidelines for tissue banking
and procurement at some point in time.
I only have the handout but James Robb, the speaker, would have is e-mail
listed in the program we received in Seattle (it's at home, not here at
work) I can look it up or if someone has it handy, please chime in for those
interested. Unofortunately, this was an underpopulated workshop, but very
informative.
Bernice

Bernice Frederick HTL (ASCP)
Northwestern University
Pathology Core Facility
ECOGPCO-RL 
710 N Fairbanks Court
Olson 8-421
Chicago,IL 60611
312-503-3723

-----Original Message-----
From: histonet-bounces <@t> lists.utsouthwestern.edu
[mailto:histonet-bounces <@t> lists.utsouthwestern.edu] On Behalf Of Jesus Ellin
Sent: Wednesday, October 13, 2010 10:05 AM
To: Kuhnla, Melissa; Phyllis Thaxton; Mahoney,Janice A; Mike Pence; Joyce
Cline; histonet <@t> lists.utsouthwestern.edu
Subject: RE: [Histonet] RE: New Cap Guidelines for Her2 and ER/PR

OK I usually do not like to chime in on this, but here I go.  How can a
true validation of a specific target be obtained if the wiggle room is 6
to 48 hr, or 8 to 72 hr.  Where is the precision and accuracy on the
results for this testing if you are going to be varying process for the
weekend vs weekday?  This is the flaw in the guidelines in my
perspective, when this much time is allowed it is like anything else.
We are going to go the path of least resistance to change, instead of
what is right.  I know that as techs we always want the best, but are
pushed to produce next day.  Techs for years have been saying more
fixation is needed on tissue.  Well enough of that.

What we do is we hold at 12 hours of fixation for all specimens no
matter what?  We document ischemic cold time through our LIS, to include
time placed in formalin, and time of first cut.  We feel that all
specimens need the same fixation times.  This is imperative to
standardize the process, but once again we also have our processors set
up in such a way that they come off at different times and our
production of H an E is in sync with this.  It might sound like a lot,
but we get most of our work done around 96 to 97 % of cases within 24
hours or less using conventional processing techniques.  

With the future relying more and more on, patient centered care, through
personalized medicine, we need to really look on how we can do the
optimal requirements, not do the minimal requirements to reach our
goals.

Jesus Ellin  

-----Original Message-----
From: histonet-bounces <@t> lists.utsouthwestern.edu
[mailto:histonet-bounces <@t> lists.utsouthwestern.edu] On Behalf Of Kuhnla,
Melissa
Sent: Wednesday, October 13, 2010 7:45 AM
To: Phyllis Thaxton; Mahoney,Janice A; Mike Pence; Joyce Cline;
histonet <@t> lists.utsouthwestern.edu
Subject: RE: [Histonet] RE: New Cap Guidelines for Her2 and ER/PR

For the weekend, we have our processor set for 36 hours in formalin and
then a hold in 70%. This allows for complete fixation and cuts down on
prolonged time in 70%

________________________________

From: Phyllis Thaxton [mailto:dchihc <@t> yahoo.com] 
Sent: Wednesday, October 13, 2010 10:32 AM
To: Kuhnla, Melissa; Mahoney,Janice A; Mike Pence; Joyce Cline;
histonet <@t> lists.utsouthwestern.edu
Subject: Re: [Histonet] RE: New Cap Guidelines for Her2 and ER/PR

 We run a weekend (Friday til Monday AM)  breast run where the tissues
are in 10% NBF for 8 hours, then in 70% alcohol for 48 hours in order to
complete processing on Monday morning. So far no problems.

Phyllis Thaxton HT(ASCP)QIHC
DCH Regional Medical Center
Tuscaloosa, AL 

________________________________

From: "Kuhnla, Melissa" <Melissa.Kuhnla <@t> chsli.org>
To: "Mahoney,Janice A" <Janice.Mahoney <@t> alegent.org>; Mike Pence
<mpence <@t> grhs.net>; Joyce Cline <Joyce.Cline <@t> wchsys.org>;
histonet <@t> lists.utsouthwestern.edu
Sent: Tue, October 12, 2010 12:02:32 PM
Subject: RE: [Histonet] RE: New Cap Guidelines for Her2 and ER/PR

I disagree.  Prolonged formalin fixation (over 48 hrs), diminishes
signals

-----Original Message-----
From: histonet-bounces <@t> lists.utsouthwestern.edu
[mailto:histonet-bounces <@t> lists.utsouthwestern.edu] On Behalf Of
Mahoney,Janice A
Sent: Tuesday, October 12, 2010 12:05 PM
To: 'Mike Pence'; Joyce Cline; histonet <@t> lists.utsouthwestern.edu
Subject: RE: [Histonet] RE: New Cap Guidelines for Her2 and ER/PR

Formalin fixation time does not impact the results of FISH as it does
IHC.
Jan M
Omaha

-----Original Message-----
From: Mike Pence [mailto:mpence <@t> grhs.net]
Sent: Tuesday, October 12, 2010 11:00 AM
To: Mahoney,Janice A; Joyce Cline; histonet <@t> lists.utsouthwestern.edu
Subject: RE: [Histonet] RE: New Cap Guidelines for Her2 and ER/PR

I don't think it matters if you do Her2 by FISH or IHC the time is still
48hr. I hope I am wrong, but I don't think I am.

Mike

-----Original Message-----
From: histonet-bounces <@t> lists.utsouthwestern.edu
[mailto:histonet-bounces <@t> lists.utsouthwestern.edu] On Behalf Of
Mahoney,Janice A
Sent: Tuesday, October 12, 2010 10:25 AM
To: 'Joyce Cline'; histonet <@t> lists.utsouthwestern.edu
Subject: [Histonet] RE: New Cap Guidelines for Her2 and ER/PR

We have decided to reflex to FISH those breasts that do not fall within
the recommended formalin fixation time.  We do work on Saturdays so it
is only the rare 3 day weekends that this comes into play. Jan M Omaha

-----Original Message-----
From: histonet-bounces <@t> lists.utsouthwestern.edu
[mailto:histonet-bounces <@t> lists.utsouthwestern.edu] On Behalf Of Joyce
Cline
Sent: Tuesday, October 12, 2010 10:10 AM
To: histonet <@t> lists.utsouthwestern.edu
Subject: [Histonet] New Cap Guidelines for Her2 and ER/PR

Does anyone have any experience with storing formalin fixed breast
tissue in 70% before processing?  I am trying to comply with the new
guidelines set forth by CAP and ASCO with regard to Her2 and ER/PR and
since my lab does not operate on the weekend we have been well above the
48 hour recommended formalin fixation time.  Does 70% affect
antigenicity for either Her2 or ER/PR?  Any information or suggestions
will be greatly appreciated.  Thanks :)

Ronda Souders
Hagerstown Medical Laboratory
301-665-4980
fax 301-665-4941
ronda.souders <@t> wchsys.org<mailto:ronda.souders <@t> wchsys.org>

________________________________
***** CONFIDENTIALITY NOTICE ***** This message contains confidential
information and is intended only for the individual named. If you are
not the named addressee you should not disseminate, distribute or copy
this e-mail. Please notify the sender immediately by e-mail if you have
received this e-mail by mistake and delete this e-mail from your system.
_______________________________________________
Histonet mailing list
Histonet <@t> lists.utsouthwestern.edu
http://lists.utsouthwestern.edu/mailman/listinfo/histonet

Sponsored by Catholic Health Initiatives and Immanuel, Alegent Health is
faithful to the healing ministry of Jesus Christ, providing high quality
care for the body, mind and spirit of every person.

The information contained in this communication, including attachments,
is confidential and private and intended only for the use of the
addressees.  Unauthorized use, disclosure, distribution or copying is
strictly prohibited and may be unlawful.  If you received this
communication in error, please inform us of the erroneous delivery by
return e-mail message from your computer.  Additionally, although all
attachments have been scanned at the source for viruses, the recipient
should check any attachments for the presence of viruses before opening.
Alegent Health accepts no liability for any damage caused by any virus
transmitted by this e-mail.  Thank you for your cooperation.

_______________________________________________
Histonet mailing list
Histonet <@t> lists.utsouthwestern.edu
http://lists.utsouthwestern.edu/mailman/listinfo/histonet

Sponsored by Catholic Health Initiatives and Immanuel, Alegent Health is
faithful to the healing ministry of Jesus Christ, providing high quality
care for the body, mind and spirit of every person.

The information contained in this communication, including attachments,
is confidential and private and intended only for the use of the
addressees.  Unauthorized use, disclosure, distribution or copying is
strictly prohibited and may be unlawful.  If you received this
communication in error, please inform us of the erroneous delivery by
return e-mail message from your computer.  Additionally, although all
attachments have been scanned at the source for viruses, the recipient
should check any attachments for the presence of viruses before opening.
Alegent Health accepts no liability for any damage caused by any virus
transmitted by this e-mail.  Thank you for your cooperation.

_______________________________________________
Histonet mailing list
Histonet <@t> lists.utsouthwestern.edu
http://lists.utsouthwestern.edu/mailman/listinfo/histonet

The information in this e-mail, and any attachments therein, is
confidential and for use by the intended addressee only. If this message
is received by you in error please do not disseminate or read further.
Please reply to the sender that you have received the message in error,
then delete the message. Although Catholic Health Services of Long
Island attempts to sweep e-mail  and attachments for viruses, it does
not guarantee that either are virus-free and accepts no liability for
any damage sustained as a result of viruses. Thank you.

_______________________________________________
Histonet mailing list
Histonet <@t> lists.utsouthwestern.edu
http://lists.utsouthwestern.edu/mailman/listinfo/histonet

The information in this e-mail, and any attachments therein, is
confidential and for use by the intended addressee only. If this message
is received by you in error please do not disseminate or read further.
Please reply to the sender that you have received the message in error,
then delete the message. Although Catholic Health Services of Long
Island attempts to sweep e-mail  and attachments for viruses, it does
not guarantee that either are virus-free and accepts no liability for
any damage sustained as a result of viruses. Thank you.

_______________________________________________
Histonet mailing list
Histonet <@t> lists.utsouthwestern.edu
http://lists.utsouthwestern.edu/mailman/listinfo/histonet

______________________________________________________________________
This message is confidential, intended only for the named 
recipient(s) and may contain information that is privileged 
or exempt from disclosure under applicable law.  If you are 
not the intended recipient(s), you are notified that the 
dissemination, distribution, or copying of this message is 
strictly prohibited.  If you receive this message in error, 
or are not the named recipient(s), please notify the sender 
at either the e-mail, fax, address, or telephone number 
listed above and delete this e-mail from your computer. 
Thank You.
______________________________________________________________________

_______________________________________________
Histonet mailing list
Histonet <@t> lists.utsouthwestern.edu
http://lists.utsouthwestern.edu/mailman/listinfo/histonet