Journal article
A rapid triage protocol to optimize cold ischemic time for breast resection specimens
Annals of diagnostic pathology, Vol.34, pp.94-97
06/2018
DOI: 10.1016/j.anndiagpath.2018.02.010
PMID: 29661737
Abstract
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.
•34.7% with malignant diagnoses underwent breast biomarker testing on resection.•18.9% of lumpectomy/mastectomy procedures required biomarker testing.•11.1% of excisional biopsies underwent biomarker testing.•Optimal CIT was achieved in 98.3% following rapid triage implementation.
Details
- Title: Subtitle
- A rapid triage protocol to optimize cold ischemic time for breast resection specimens
- Creators
- Ellen G East - University of Michigan–Ann ArborMatthew Gabbeart - University of Michigan–Ann ArborEmily Roberts - University of Michigan–Ann ArborLili Zhao - University of Michigan–Ann ArborJulie M Jorns - Medical College of Wisconsin
- Resource Type
- Journal article
- Publication Details
- Annals of diagnostic pathology, Vol.34, pp.94-97
- Publisher
- Elsevier Inc
- DOI
- 10.1016/j.anndiagpath.2018.02.010
- PMID
- 29661737
- ISSN
- 1092-9134
- eISSN
- 1532-8198
- Language
- English
- Date published
- 06/2018
- Academic Unit
- Biostatistics
- Record Identifier
- 9984274664202771
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