>From the pathologist's viewpoint, underfixation is the problem in
breast tissue, starting with the H & E. I'm seeing much more
satisfactory sections now that overnight fixation is mandatory.
The loss of turnaround time does put us at a disadvantage with the
commercial labs, who are under no such constraints. I think that
pathologists need to be passing this information on to the breast
surgeons, that turnaround is going to be a bit slower. This point was
emphasized to me in my residency forty years ago - that patients need
to be told that, while their anxiety about their test results is real,
that what they need is the right diagnosis and not the fast diagnosis,
and that their pathologists are working with all possible speed.
A couple of years ago I did a talk on IHC, and exported some
photomicrographs from our very primitive photomicroscopy application
to PhotoShop, so I could improve their appearance. I was amazed that I
could take a weak-positive HER2 image and make it show anything from 0
to 3+ positivity with the proverbial click of the mouse.
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