Re: Breast specimens

This thread about pathologists overstuffing breast tissue into cassettes gets 
repeated every few months, and for good reason.

The pathologist needs a histotechnologist to assist with grossing, and in 
many labs has one. This histotech needs to be ready to remind the pathologist 
when what goes into the cassette isn't suitable. Because I work in many 
different laboratories, I constantly have to adjust to different processing 
standards, and I rely heavily on the histotechnologist to tell me what will 
get through and what won't.

There are a lot of tricks for preparing breast tissue. I used to use an acid 
fixative to harden slices of fatty breast tissue, but you really can't do 
that any more because of HER2/neu specifications. I fairly often take a wire 
localization specimen, ink it, slice it as thin as I can, stick the slices to 
a paper towel, and leave them in formalin to fix flat for a couple of hours. 
It's then much easier to trim the slices - and also to repeat the specimen 
radiography if I think I've lost track of the microcalcifications when I cut 
the specimen apart.

Bob Richmond
Samurai Pathologist
Knoxville TN

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