Will the breast panel not be processed if the specimen reached the lab three hours late?

Question

Hello doctor,

If a breast specimen is sent to the laboratory for routine histopathology and the breast panel is delayed by three hours, will there be a problem in running the tests? Will the breast panel not be processed because of the delay?

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern and will definitely help you out. A breast specimen should be kept in formalin fixative within one hour of resection for optimal immunohistochemistry (breast panel) results. The most recent guidelines for ER (estrogen receptor), PR (progesterone receptor), and HER2 testing recommended minimizing delay in fixation time (cold ischemia time) to less than one hour.

Delay in fixation may convert a biomarker status from positive to negative, decrease the overall score, or make the assay uninterpretable. Although CAP guidelines require tissue to be fixed within one hour, clinically significant changes in the breast biomarkers may not occur until 3 or 4 hours of delay in formalin fixation. So breast panels can still be processed, but the guidelines recommend fixation within one hour for optimal results. If it is just three hours, probably results will not be affected much.

I hope it helps. Take care.