A rapid triage protocol to optimize cold ischemic time for breast resection specimens. Ann Diagn Pathol 2018 Jun;34:94-97
Date
04/18/2018Pubmed ID
29661737DOI
10.1016/j.anndiagpath.2018.02.010Scopus ID
2-s2.0-85044590656 (requires institutional sign-in at Scopus site) 3 CitationsAbstract
Prolonged time from specimen excision to adequate formalin exposure, or cold ischemic time (CIT), negatively impacts estrogen receptor (ER), progesterone receptor (PR) and HER-2 biomarker studies routinely performed on breast specimens. Current guidelines recommend CIT of ≤1 h. Since formalin penetrates resections slowly, optimal fixation requires incision. We evaluated the efficacy of a rapid triage protocol developed to optimize CIT. We identified 2821 specimens: 650 (23.0%) excisional biopsies (EB), 1051 (37.3%) lumpectomies, and 1120 (39.7%) mastectomies. CIT was available for 2362 (83.7%), with 1845 (78.1%) ≤1 h and 2323 (98.3%) ≤4 h. IHC was performed in 533/2821 (18.9%) and was associated with lumpectomy and mastectomy procedures when compared to EB. However, IHC was also performed on 11.1% (72/650) of EB specimens despite EB being significantly less likely to have CIT recorded (468/650; 72% for EB vs. 1894/2171; 87.2% for lumpectomies/mastectomies). Our study highlights the need for rapid triage of breast resections with known or suspected malignant diagnoses and outlines our procedure for optimizing CIT. Additionally, we advocate treating ALL breast resections as having the potential of being malignant and requiring biomarker studies for which optimal CIT is of great importance.
Author List
East EG, Gabbeart M, Roberts E, Zhao L, Jorns JMAuthor
Julie M. Jorns MD Professor in the Pathology department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdolescentAdult
Aged
Aged, 80 and over
Breast
Breast Neoplasms
Child
Cold Ischemia
Female
Formaldehyde
Humans
Mastectomy
Mastectomy, Segmental
Middle Aged
Receptor, ErbB-2
Receptors, Progesterone
Specimen Handling
Triage
Young Adult
