Re: Breast specimens
Does the FDA approved Her2 methods address the use of MW enhanced formalin
fixation or is it just assumed that formalin fixation is acceptable by any means
> 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
> Donna Willis
> Histology Lab Manager
> Harris Methodist Fort Worth, Texas
> -----Original Message-----
> 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
> > 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
> > Tracy Smith
> > Anatomic Pathology Scientist
> > Children's Hospital and Clinics
> > Phone(651)220-6561
> > Fax(651)220-7178
> > Tracy.Smith@Children'sHC.org
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