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" <firstname.lastname@example.org>,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
> > email@example.com
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