title: Brief formalin fixation and rapid tissue processing do not affect the sensitivity of ER immunohistochemistry of breast core biopsies.
abstract: OBJECTIVE
  Recent studies have questioned the supporting evidence for the American Society of Clinical Oncology/College of American Pathologists (ASCO/CAP) guidelines of the 8-hour minimum fixation time required for estrogen receptor immunohistochemistry (ER-IHC) assays in breast cancer.
  
  
  METHODS
  We investigated whether brief formalin fixation together with rapid tissue processing affects the sensitivity of ER in core breast biopsies. Five core samples each from 22 mastectomy specimens were collected and fixed in 10% formalin for periods ranging from 30 minutes to 1 week. Core 5 was fixed and processed according to the ASCO/CAP guidelines. ER-IHC was performed following heat-induced antigen retrieval using antibody 1D5. The proportion and intensity of reaction was recorded using the Q score.
  
  
  RESULTS
  Five of 22 cancers were ER negative in all cores. In 17 ER-positive cases, no differences were found in the intensity of reaction between 30 minutes and 1 week of formalin fixation. Similarly, no difference was observed in the Q scores of rapidly and conventionally processed control tumor cores.
  
  
  CONCLUSIONS
  Brief formalin fixation along with rapid processing has no negative effect on the sensitivity of ER-IHC in breast core biopsies. This combination significantly reduces the turnaround time for preparing breast needle biopsy specimens.
authors.affiliation: Dept of Pathology, University of Miami, Jackson Health System, 1611 NW 12th Ave, Holtz-2147, Miami, FL 33136; mnadji@aol.com.
authors.forename: Victoria
authors.initials: V
authors.lastname: Sujoy
authors.forename: Mehrdad
authors.initials: M
authors.lastname: Nadji
authors.forename: Azorides R
authors.initials: AR
authors.lastname: Morales
mesh_terms: D001707:Biopsy, Needle; D001943:Breast Neoplasms / Q000473:pathology*; D018270:Carcinoma, Ductal, Breast / Q000473:pathology*; D047628:Estrogen Receptor alpha / Q000032:analysis*; D005260:Female; D005557:Formaldehyde; D006801:Humans; D007150:Immunohistochemistry / Q000379:methods*; D008408:Mastectomy; D012680:Sensitivity and Specificity; D016707:Tissue Fixation / Q000379:methods*
chemical_list: C506487:ESR1 protein, human; D047628:Estrogen Receptor alpha; D005557:Formaldehyde
keywords: ASCO/CAP guidelines; Conventional processing; ER; Estrogen receptor; Formalin fixation; IHC; Rapid processing