RE: Breast specimens
Let me put a new light on the breast fixation/processing discussion. One
thing that you need to keep in mind if what method of Her-2-neu is being
used in the lab. When using the FDA approved DAKO Herceptest or the FDA
Ventana Pathway method you have to use formalin as the fixative.
In our lab we make sure the specimen is fixed properly by using microwave
technology before the samples are placed on the tissue processor. All
specimens that are received today are processed tonight. There is no need
to hold tissue overnight for fixation. Also all slides are ready for the
pathologist by 8:00 the next morning. When fixation is complete, you can
decrease the formalin time on the tissue processors. We have changed the
solutions somewhat on the processor so that the a xylene is placed between
the 100% Alcohol. This Xylene starts the defatting process. The tissue then
goes into more 100% alcohol for dehydration. The tissue sections are
Histology Lab Manager
Harris Methodist Fort Worth, Texas
From: Donna Carlton [mailto:DCarlton@samhealth.org]
Sent: Tuesday, April 23, 2002 12:48 PM
To: 'Tracey Smith'; firstname.lastname@example.org; email@example.com
Subject: RE: Breast specimens
just a suggestion:-) I work in a clinical lab where turn around time is 24
hours for most tissues. The pathologist does leave the tissue to set in 10%
Formalin overnight for fixation. I use alc formalin on my tissue processor,
you may want to try Anatech's product. Try different times to see what
works best. You have nothing to loose and Anatech is pretty good about
helping you work out the details. Breast when it is cut in right is oh so
much better, I agree, However it has been my experience that sometimes it
does not want to cut well even then. I use a VIP processor for approx. 200
blocks and do the following:
1 hour in 10% NBF
45 min in fresh alc formalin
45 min in the rest of the process.
Paraplast plus with dmso in it.
All four tech's in the lab can obtain 3 micron sections routinely on large
breast specimens. If they are to thick, it won't work, but they can be
thicker and you can get away with it.
Everyone does it different and I am sure there are many ways to get to Rome.
This is just one way that seems to work for us.
> -----Original Message-----
> From: Tracey Smith [SMTP:Tracey.Smith@childrenshc.org]
> Sent: Tuesday, April 23, 2002 10:17 AM
> To: firstname.lastname@example.org; email@example.com
> Subject: Re: Breast specimens
> Connie, you have to convince the prosector that thin is in,more so when
> cutting fat. You could have them cut in the tissue and fix overnight(as
> you are), but then have them come back and retrim the tissue again. They
> may need more cassettes but I've always advocated that one well
> preserved,readable slide beats 4 "rim-shots". If they complain that it is
> too hard to trim tissue thin remind them that you are attempting to cut it
> 1000's of times thinner using essentially that same blades and tools.
> Hope this helps>>> "Connie P." 04/22/02 06:16PM >>>
> Could we please revisit my current nemesis, which is surely going to drive
> me into leaving Histology forever and seeking a lucrative highly paying
> successful career?
> I need help/advice/suggestions regarding handling breast specimens so that
> they are well preserved, easy to cut on the microtome, instead of
> partially raw tissue which requires the cut and scoop method to obtain a
> I plead with the residents (1st yrs.) to trim them so that they fit in the
> cassette without touching the sides, and cut them to 2mm in thickness. Of
> course, most times they are 4mm or more. They are then placed into
> cassettes and held overnight in 10%NBF. They get put on the processor the
> next evening. I tried alcoholic formalin, saw no difference. Large breast
> lymph nodes are just as bad if not worse, raw in the centers. The small
> ones are usually fixed O.K. Does anyone have a tried and true method for
> handling large breast specimens which works for them with few exceptions?
> If so, please share it, I will be forever in your debt.
> Connie L. Probert
> Detroit, Michigan
> Tracy Smith
> Anatomic Pathology Scientist
> Children's Hospital and Clinics
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