title: The effect of delay in fixation, different fixatives, and duration of fixation in estrogen and progesterone receptor results in breast carcinoma.
abstract: Accurate determination of estrogen receptor (ER) and progesterone receptor (PR) status in breast carcinoma is essential. Preanalytic variation may contribute to discordant results. Recently, American Society of Clinical Oncology (ASCO)/College of American Pathologists (CAP) made recommendations to normalize fixation for breast biomarkers. To evaluate this, a 4-cm invasive lobular carcinoma was processed according to ASCO/CAP guidelines. The remainder was stored fresh at 4°C for 4 days and cut into biopsy-sized pieces. Each was fixed in 10% formalin, Pen-Fix (Richard-Allan Scientific, Kalamazoo, MI), Bouin solution, Sakura Molecular Fixative (Sakura Tissue-Tek Xpress, Torrance, CA), zinc formalin, or 15% formaldehyde for times ranging between 1 and 168 hours. Immunohistochemical studies for ER and PR were performed and interpreted. After 4 days at 4°C, all samples showed no degradation or ER/PR staining differences, except 2 Bouin-fixed samples, in comparison with the patient's sample processed according to ASCO/CAP guidelines. In our study, the preanalytic variables of fixative type, fixation time, and 4 days of ischemic time did not affect immunohistochemical accuracy for ER/PR.
authors.affiliation: Dept of Pathology and Laboratory Medicine, UCLA Center for the Health Sciences, Los Angeles, CA 90095, USA.
authors.forename: Sophia
authors.initials: S
authors.lastname: Apple
authors.forename: Richard
authors.initials: R
authors.lastname: Pucci
authors.forename: Alarice C
authors.initials: AC
authors.lastname: Lowe
authors.forename: Itsushi
authors.initials: I
authors.lastname: Shintaku
authors.forename: Saeedeh
authors.initials: S
authors.lastname: Shapourifar-Tehrani
authors.forename: Neda
authors.initials: N
authors.lastname: Moatamed
mesh_terms: D001943:Breast Neoplasms / Q000378:metabolism* / Q000473:pathology / Q000601:surgery; D018275:Carcinoma, Lobular / Q000378:metabolism* / Q000473:pathology / Q000601:surgery; D005260:Female; D005404:Fixatives; D006801:Humans; D008495:Medical Oncology / Q000592:standards; D010336:Pathology / Q000592:standards; D017410:Practice Guidelines as Topic; D011309:Preservation, Biological / Q000379:methods* / Q000592:standards; D011960:Receptors, Estrogen / Q000378:metabolism*; D011980:Receptors, Progesterone / Q000378:metabolism*; D012955:Societies, Medical; D013997:Time Factors
chemical_list: D005404:Fixatives; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone