RE: [Histonet] Same Day Breast Biopsy Results
Let me try to contribute with my "2 cents":
It seems to me that there is more to it than the just "same day" breast biospy issue.
This can be done and is done daily at labs with the new Sakura Throughput tissue processing technology. It is done in less than 4 hours and there is no limit to IHC tests. This new technology is not reflected in the regulations that have been mentioned but rest assured that the pathologists working in labs with that technology are not going to compromise a diagnostic for speed sake.
Thank you for your responses! I have had three run-ins with this
particular surgeon and neither of us is willing to budge. Thank you for
the affirmation that I am not the one out in left field...................
I plan to stand my ground and will not compromise patient care.
Charles is completely correct. We do no do same day breast biopsies for
the same reasons and for the FDA requirements for ER/PR and Her2Neu
analysis. This surgeon is way out in left field and your chief
pathologist needs to educate him. I had the same problem here with one
of our surgeons and both the chief pathologist and I gave him a short
course on fixation and unfixed specimens. I even showed him the
difference in the results of poorly fixed vs fixed tissue slides. He was
most impressed and has not pressured me to submit unfixed or poorly
fixed breast tissue again. Surgeons do not know or understand the
techniques and procedures of excellent histology. They have to be gently
educated so that they can provide the best patient care.
Diane C. Gladney, HT (ASCP)
Supervisor, Histology Dept.
Moncrief Army Community Hospital
Dept. of Pathology
4500 Stuart St.
FT. Jackson, SC 29207
In my opinion what your surgeon is asking for is detrimental to proper
patient care, results in substandard slides and opens both the hospital
and pathologist to potential malpractice. Breast, because of its fatty
nature is slower to fix and process than other tissues and rush
processing usually results in poor slides. A recent post on histonet
stated that they have to reprocess "a lot of blocks", mainly breast,
because of difficulty in sectioning. What if that tissue, wasted in the
first attempts at processing contained the tumor and the reprocessed
tissue is now tumor free? With today's imaging studies tumors and
lesions are being found earlier and thus smaller that ever. You can't
afford to waste any tissue in an attempt to rapid process. All this
aside, what is the surgeon going to do with same day results? How are
same day results going to affect his care of the patient? How is
waiting 24 to 48 hours going to have a negative impact on his care for
the patient? I suspect, the surgeon only want to look good to the
patient by giving them the report quickly. The bottom line is that your
Chief Pathologist is going to have to put his foot down and say NO. It
is better for the patient to have good histology and a confident
diagnosis than speed and a suspect diagnosis. Personally, we fix all
breast tissues, even cores, overnight before processing and get great
results. You can tell your surgeon that my facility will not jeopardize
patient care for speed.
Charles Embrey Jr., PA(ASCP)
Carle Clinic, Illinois
I would provide him with the FDA requirements. Surely he would not want to
compromise the treatment of his patient.
Saint Joseph's Hospital
5665 Peachtree Dunwoody Rd NE
Atlanta, GA 30342
404-851-7376 - Phone
404-851-7831 - Fax
Subject: [Histonet] Same Day Breast Biopsy Results
I need information on providing same day results on breast biopsy
specimens. Is anyone out there doing this???
We have a surgeon on staff at our institution that is demanding same day
rush breast biopsy results. We often rush other types of biopsies and
provide same day results, but for obvious reasons (fatty, Her2 fixation,
etc.) we do not provide this service for breast tissue. I do provide first
am results. He has insisted that other institutions are providing same day
breast results and is not happy with waiting till 8 am the next morning. I
called other labs in our area and they are not doing same day breast
results for the same reasons we are not.
Can anyone help me with this? Your help is greatly appreciated!
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