I'm not sure this answers your question but I believe the CAP
"guidelines" are based largely upon the article published by Neal
Goldstein et. al. entitled
" Minimum Formalin Fixation Time for Consistent Estrogen
Receptor Immunohistochemical Staining of Invasive
Neal S. Goldstein, MD, Monica Ferkowicz, MT(ASCP), PathA(AAPA), Eva
Anju Mani, MD, and Farnaz Hastah, MD
Am J Clin Pathol 2003;120:86-92
This work likely led to the ASCO/CAP publication upon which the current
requirements are based
"American Society of Clinical Oncology/College of
American Pathologists Guideline Recommendations for
Human Epidermal Growth Factor Receptor 2
Testing in Breast Cancer"
Arch Pathol Lab Med-Vol 131, January 2007
I have both in pdf for anyone who can't get their hands on these
publications and would like to email me.
Vinnie Della Speranza
Manager for Anatomic Pathology Services
165 Ashley Avenue Suite 309
Charleston, South Carolina 29425
Tel: (843) 792-6353
Fax: (843) 792-8974
[mailto:firstname.lastname@example.org] On Behalf Of Lott,
Sent: Friday, June 15, 2007 12:37 PM
Subject: [Histonet] Fixation for Her-2/neu -Where's the Beef???
.....been a lot of talk about this already, I'm aware of that. Now I
want to know if there is any "real" scientific" basis for the new CAP
guideline for Her-2 IHC fixation that states "No less than 6 hrs. and no
more than 48 hrs. in aqueous NFB." Any documented, peer-reviewed,
My sense is that this guideline really does represent best practice.
Most of us do well to get our breast specimens fixed for 6 hrs. in NBF!!
However, is there really some difference in performance of the Her-2 IHC
assay if a breast case is fixed for 48 hrs vs. one fixed for 54 hrs. or
72 hrs. (i.e. weekend/ holiday scenario). UNDER-fixation would seem to
be so much more of issue than OVER-fixation.
It's this top end that bothers me so much!!!
I am not aware of real data to support this new guideline! Does anyone
out there know anything different?????
Robert L. Lott, HTL(ASCP)
Manager, Anatomic Pathology
LabFirst / Trinity Medical Center - formerly
Montclair Baptist Medical Center
800 Montclair Road
Birmingham, AL 35213
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