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

[McMahon, Loralee A]

If our cases are needle cores they are almost immediately put into formalin from the patient.  That time is recorded by the nurse or the clinician that took the specimen.  
The larger breast samples are received fresh from the OR and are immediately grossed either by a PA or resident.  Those samples are examined, sliced (to expose the surface area of the specimen) and placed into formalin.  That is when the fixation time is recorded for the larger specimens.  

Loralee McMahon, HTL (ASCP)
Immunohistochemistry Supervisor
Strong Memorial Hospital
Department of Surgical Pathology
(585) 275-7210
________________________________________
From: histonet-bounces <@t> lists.utsouthwestern.edu [histonet-bounces <@t> lists.utsouthwestern.edu] On Behalf Of Bill B. [bill501 <@t> mindspring.com]
Sent: Wednesday, October 13, 2010 3:12 PM
To: histonet <@t> lists.utsouthwestern.edu
Subject: RE: [Histonet] RE: New Cap Guidelines for Her2 and ER/PR

How do you define fixation time? A half pound hunk of fat with a tumor in the middle will remain unfixed until blocked. A small biopsy will start fixing almost immediately.

Bill

At 1:51 PM -0400 10/13/10, Kuhnla, Melissa wrote:
>Fixation prior to the processor will not exce4ed 12 hrs.  That is why we
>program the processor for 36...not to exceed 48.
>
>
>
>________________________________
>
>From: Mike Pence [mailto:mpence <@t> grhs.net]
>Sent: Wednesday, October 13, 2010 11:04 AM
>To: Kuhnla, Melissa; Phyllis Thaxton; Mahoney,Janice A; Joyce Cline;
>histonet <@t> lists.utsouthwestern.edu
>Subject: RE: [Histonet] RE: New Cap Guidelines for Her2 and ER/PR
>
>
>
>How much time is the tissue in formalin prior to going in the processor?
>Your total time in formalin can not exceed 48 hr. And you will still
>need to validate your process if you hold your tissue longer than
>"normal processing" time in 70% (ie. more than 1 hr).
>
>       -----Original Message-----
>       From: Kuhnla, Melissa [mailto:Melissa.Kuhnla <@t> chsli.org]
>       Sent: Wednesday, October 13, 2010 9:45 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>

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