Re: Breast Tissue Fixation again

From:Vinnie Della Speranza <>

For those who are using a different fixative than 10% formalin, 
1.  can you please comment on how your fixative affects Her2neu and ER/PR staining and 
2.  specifically regarding Her 2 neu, doesn't the use of a fixative other than formalin violate the manufacturer's instructions of the FDA approved test kits ( Dako Hercept and Ventana Pathway) ? I would think that savy CAP inspectors will look for such things.


Vinnie Della Speranza
Manager for Anatomic Pathology Services
Medical University of South Carolina
165 Ashley Avenue
Suite 309
Charleston, SC  29425
ph:  (843) 792-6353
fax: (843) 792-8974

>>> <> 01/26/01 10:58PM >>>
John McClure, a pathologist in Fridley MN, writes in response to Debra 
Ritter's query:

>>We have used both Davidson's Fixative ( I believe that the Samurai 
pathologist has a recipe on his web page) or the commercially available 
Dissectaid is a commercial product that seems similar. Both have formalin, 
alcohol, and acetic acid. They both do a nice job of fixing marking ink to 
the surface of the specimen as well as firming up the fat. I think that the 
most important contribution of these fixatives is to make it easier to cut 
appropriately thin sections.<<

Indeed, I've got the formula for Davidson's fixative, with references, at 
It consists of three parts water, three parts alcohol, two parts 37% 
formaldehyde, one part glacial acetic acid.

Breast tissue needs to be cut very thin in the first place - pathologists=20
simply must learn to do this, and too many of them get out of residency 
without understanding the importance of this. Give 'em hell.

I used to use Davidson's fixative for breast tissue, but have been reluctant 
to do so in recent years because of the limited information available about 
its effect on immunohistochemical staining, particularly on the rigidly 
prescribed HER2/neu procedure.

Bob Richmond
Samurai Pathologist
Knoxville TN

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