[Histonet] Breast fixation

Cartun, Richard Richard.Cartun at hhchealth.org
Fri Jul 31 14:28:44 CDT 2015

There are several studies (one listed below) that have addressed the issue of fixation past the "recommended" 72 hour maximum.  In my opinion, the science behind these fixation recommendations is "weak" at best.  In my own experience, I have seen no problem whatsoever going well past 72 hours of fixation.  The majority of breast cases will show internal positive controls for ER and PR to validate that the tissue is satisfactory for testing.  Remember, working with your pathologist(s) you can perform your own validation on-site for extended fixation time.  The real culprit for poor ER, PR, and HER2 IHC results is "inadequate" fixation.

Reference:  Tong LC, Nelson N, Tsourigiannis J, et al.:  The effect of prolonged fixation on the IHC evaluation of ER, PR, and HER2 expression in invasive breast cancer:  A prospective study.  Am J Surg Pathol 2011;35:545-552.


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) 972-1596
(860) 545-2204 Fax

-----Original Message-----
From: Heckford, Karen - SMMC-SF via Histonet [mailto:histonet at lists.utsouthwestern.edu]
Sent: Wednesday, July 29, 2015 11:02 AM
To: histonet at lists.utsouthwestern.edu
Subject: [Histonet] Breast fixation

Good Morning,
I have a question about breast fixation.   I am in a little bit of a pickle with the 6-72 hour rule for the fixation on breast tissue.   Friday I am getting 2 breast cases in the afternoon and both will not have the required minimum 6 hour formalin fixation for my per diem to cut early Saturday morning.   He will not be able to make it in again until Monday night.  The tissue will be about 3-4 hours (this includes time on the processor)  over the 72 hour maximum.    Does anyone have any suggestions on what can be done?  We are a one person show here.


Karen Heckford HT ASCP CE
Lead Histology Technician
St. Mary's Medical Center
450 Stanyan St.
San Francisco, Ca. 94117
415-668-1000 ext. 6167
karen.heckford at dignityhealth.org
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