RE: Sentinel node

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From:"Jennings-Siena, Debbie" <>
To:"'Bill Sinai (Anatomical Pathology)'" <>,
Date:Thu, 23 Sep 1999 10:35:57 -0500

Here at Baylor, we are holding the lumpectomies, or breasts, or melanomas
for 48-60 hours before submitting sections.  The sentinel nodes that were
frozen are submitted right away.  We have been told by our radiation safety
department, that this is unnecessary but the pathologists are more
comfortable holding them.  Also the waste, such as paper towels or gauze is
held separately in a plastic bucket and emptied only once a week (Monday).
The half life of technicium is 60 hours so by Monday all traceable amounts
of radiation are gone.  The containers must be labeled with radioactive
stickers in the OR and these must be removed before the specimen is
discarded.  After gross dissection, the specimens are stored with our
regular specimens minus radioactive label.  The only precautions while
grossing are regular BSI and any cut resistent protection that you may
normally use in your hospital.  There is one drawback to holding the
specimens for 2 days and that is that the ER, PR stains are not as good as
they were before, but we are working on a new procedure, where a piece of
tissue will be removed and submitted like the sentinel nodes.  I hope this
helps, if I can answer any more questions, please let me know.  Thanks
Debbie Jennings-Siena
Histopathology Manager
Baylor University Medical Center
Dallas, Texas

	-----Original Message-----
	From:	Bill Sinai (Anatomical Pathology)
	Sent:	Thursday, September 23, 1999 8:10 AM
	Subject:	Sentinel node

	Breast and sentinel nodes received for Histopathology still contain 
	an amount of Technetium when received in  the laboratory.  What 
	precautions (if any) do laboratories have in place to protect staff 
	from exposure to this risk. 

	It has been suggested from several sources that the radiation 
	levels are minimal, however, there seems to be some dispute among 
	pathologists as to how the specimen should be:

	1.  Handled and stored prior to dissection.
	2.  Handled at dissection.
	3.  Any protection or warning that should be offered to staff.
	4.  Stored after dissection.

	Any information would be appreciated.
	Many thanks.

	Bill Sinai
	Department Manager
	Tissue Pathology
	ICPMR Westmead Hospital 
	Phone 61+2+9845 7774  Fax 61+2+9687 2330

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