Re: Breast Tissue X-Ray

Frank Tringale, Supervisor of Histology Services, Stanford University Medical 
>>In our lab we XRay all breast bx and mastectomy specimens received in the

gross room. The procedure that we have used for several years is to ink the

specimen when it is received and let it sit overnight in formalin. The Path

Assistant will slice the breast, the next day, after it is oriented, in thin

slices and place on x ray film. After the breast has been x ray'd the long

pieces of tissue are layed flat on a tray covered in formal alcohol until

the resident looks at the film and identifies calcifications. The resident

then cuts the sections from the strips of tissue and blocks it for

processing that night. I would like to know what others are doing for their

breast protocols.<<

Seems like a procedure designed to diffuse responsibility and assure 
autolysis - I'm glad to see that a new generation of pathologists is being 
taught the management skills we old timers lack. Why aren't the residents 
properly preparing the tissue the first day, so that it fixes overnight after 
dissection? This procedure contravenes the FDA requirements for HER2/neu that 
we've been talking about on this list. Specimen radiography shouldn't be 
routine, but should be reserved for cases where there is doubt about where 
the calcifications are.

Bob Richmond
Samurai Pathologist
Knoxville TN

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