RE: [Histonet] HER2 and the 48 hour rule
You can delay start it just as long as the tissue is not in formalin (from
gross until it leaves the last formalin on the processor) longer than 48
hours. Let's say the breast hits formalin at 12PM on a Friday. It has to be
out of formalin by 12PM on Sunday. Even with the longest processing schedule
it will most likely be ready around 12AM Monday morning. Most likely you
will not use the maximum 48 hours due to this. Someone will have to come in
on the weekend regardless the time. Who has HER2 watch this weekend??
Douglas D. Deltour HT(ASCP)
Professional Pathology Services, PC
One Science Court
Columbia, SC 29203
PROFESSIONAL PATHOLOGY SERVICES, PC
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[mailto:firstname.lastname@example.org] On Behalf Of sheila adey
Sent: Tuesday, January 23, 2007 2:36 PM
To: email@example.com; firstname.lastname@example.org;
Subject: Re: [Histonet] HER2 and the 48 hour rule
This prompts a new question.
I'm curious as to whether other labs that don't work weekends leave their
tissues in formalin with a delayed start or do you start the processor right
away and leave the tissues in Xylene as stated below?
Sheila Adey HT MLT
Port Huron Hospital
>From: Patti Loykasek
>To: "Peterson, Dan" <email@example.com>,histonet
>Subject: Re: [Histonet] HER2 and the 48 hour rule
>Date: Tue, 23 Jan 2007 10:06:08 -0800
>Welcome to the new world of Her2 testing! There will definitely be changes
>in the lab as a result of the ASCO/CAP Her2 testing guidelines. I urge all
>techs to get a copy of the guidelines and read them.
>That being said, the time in fixation is important for Her2 testing. With
>heat retrieval I think that too little fixation is worse than >48 hours,
>for now we must comply with 6-48 hours. I was taught (a long time ago) that
>it is best practice for the weekend schedule fixation to reflect the rest
>the week, and that it is preferable to leave the tissue longer in xylene.
>That xylene would have less bad effects than longer time in formalin. A
>longer time in alcohol would be deleterious to many IHC stains, and not
>recommended for Her2.
>Whatever schedule changes you decide to implement, hopefully you can test
>your new schedule on some tissue before full implementation of a new
>Patti Loykasek BS, HTL, QIHC
> > Hello Histonetters!
> > Maybe this has been discussed before, and if it has, I apologize in
> > advance, but I need a little input. Now that the CAP has mandated a 6
> > -48 hour window of fixation time for specimens that may have Her-2 neu
> > performed, what are you doing about weekend specimens? We JUST (after
> > 25+ years) got rid of the need for techs to come in on Saturdays, and
> > would like to be able to continue this trend. However if a breast bx is
> > done at an outside account on a Thursday afternoon, and does not get
> > grossed by our staff until Friday, right now a our processors are set to
> > start up Sunday afternoon for Monday morning (Kind of over 48 hrs). So
> > here are my questions:
> > Do you set up the processor to sit in 70% OH after the formalin fix? Do
> > you let it sit in the paraffin from Saturday until Monday? (Is heat too
> > prolonged?)
> > Or do I have to break the news to staff that if their name is up, and a
> > breast bx comes in, they're coming in Saturday am?
> > We do not have a microwave processor (yet), but soon.
> > Any and all responses will be greatly appreciated!
> > Daniel R Peterson HT(ASCP)
> > Histopathology Section Head
> > Meriter Laboratories
> > (608)-267-6557
> > firstname.lastname@example.org
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