Re: Breast specimens

From:Aidan Schurr

Hi Connie,

Unfortunately there is no "wonder solution" that will deal with tissue that has been cut too thick.  This is because the tissue presses up against the inside surfaces of the cassette.  This means the fluids (no matter what they are) cannot infiltrate properly, leading to poorly processed tissue.  It's a matter of educating those Path's!!  My solution to this has been twofold:  1 - watch them at cutup and ask them to thin down any tissue greater than 3mm thickness.  It does help if you tell them exactly *why* you need the tissue to be thinner.  Constant hounding does work eventually!  2 - get them in to try to cut the section the next day.  Again, tell them why the tissue is that difficult to cut.  Maybe compare to a "well processed" block of fat.  There seems to be this subconscious idea that it is something we do, or some fault with the processing cycle that causes these difficulties.  It's not easy, but you can change that mentality!  

There is no good reason that fresh breast tissue cut 2mm thick should not be perfectly sectionable after a 14hr overnight process!

regards (and best wishes!)

Aidan.


__

aidan schurr  b.m.l.sc
section head, histology
hutt valley district health board
lower hutt
new zealand

aidan.schurr@hvh.co.nz
++64 4 570 9173 (direct)
++64 4 570 9214 (fax)

>>> "Connie P."  23/04/2002 >>>
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 slide. 
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





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