The guidelines recommend slicing breast specimens at 5 to 10 mm intervals before fixing in formalin. Should specimens be refrigerated without fixative until this can be done?
No. Refrigeration delays fixation, which has a detrimental effect on immunostaining. The new testing guidelines require that specimens that will be subject to HER2 testing be placed in formalin as soon as possible after excision; any significant delay in fixation is now considered unacceptable In addition to placing in fixative as soon as possible, the guidelines also recommend slicing the specimen at regular intervals to ensure adequate fixation throughout. Since most cases also require assessment of specimen margins, institutions must develop procedures to ensure proper handling of breast excision specimens. As with any other intraoperative consultation, a pathologist (or other appropriately trained person under the direct supervision of a pathologist) must be available to handle these specimens.
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