[Histonet] Histonet Digest, Vol 158, Issue 22 Breast Specimen

[Steve McClain]

In my experience, rushing to process fatty or inadequately fixed specimens is a fool's game.
In my opinion, this problem cannot be solved by the histotechs- it begins with the grossers and is one for the pathologists to solve at the grossing bench.  

Suggestion #1 Do nothing and let the medical director pathologist/ sign it out/deal w this individual case.

Suggestion #2  Sometimes a decent section can be obtained after changing paraffin. 
[place the blocks in molds and melt the blocks and change to new paraffin- let them sit in the embedding center in the new paraffin for 60 minutes. Re-embed in new paraffin (2 changes) and then re-embed.]

Suggestion #3 Reprocess these blocks if permitted, recognizing that breast markers (if cancerous) may be erroneous.

Suggestion #4 Seek to prevent future occurrences by adjusting behavior at the grossing bench.
a) first ensuring adequate fixation and b) second ensuring adequate length/time of processing.  


Steve A. McClain, MD
631 361 4000

What is the best way to handle Breast specimens that were grossed too thick and did not process well?  Our medical director does not want us to reprocess the tissue but it is almost impossible to get even a remotely decent section. If anyone has any other tips please let me know as soon as possible

-- 

Charles Riley HT(ASCP)CM

Histopathology Coordinator/ Mohs**********************