Skip to main content
SpringerLink
Log in

Short Formalin Fixation and Rapid Microwave Processing Do Not Affect HER2 Testing

  • Chapter
  • First Online:
Pre-Analytics of Pathological Specimens in Oncology

Part of the book series: Recent Results in Cancer Research ((RECENTCANCER,volume 199))

Abstract

Correct and consistent results in estrogen and progesterone receptors, HER2 and Ki67 proliferation rate testing are a basic prerequisite for selecting therapy and individualizing prognosis in patients with breast carcinoma. Preanalytic factors, including time from excision to fixation and time and type of fixation, are critical to obtain reproducible and reliable results in these immunohistochemical assays and their relevance has long been stressed. The ASCO-CAP guidelines on HER2 testing indicated that histologic material including both biopsies and surgical specimens must be fixed for at least 6 h in order to obtain reliable results; however, there is a very limited scientific support regarding the setting at 6 h the minimum fixation time. We demonstrate that with a short fixation time (30′) and rapid processing with MW technology (69′), it is possible to achieve an adequate and reproducible assessment of HER2 status. We obtained similar results in HER2 evaluation in breast carcinoma biopsies treated with this short protocol and in the corresponding surgical specimens processed routinely with a 24 h formalin fixation time—i.e., within the guidelines interval time.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 54.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Goldhirsch A, Winer EP, Coates AS, Gelber RD, Piccart-Gebhart M, Thürlimann B, Senn HJ (2013) Personalizing the treatment of women with early breast cancer: highlights of the St Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer 2013. Ann Oncol 24(9):2206–2223

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  2. Allison M (2010) The HER2 conundrum. Nat Biotechnol 28(2):117–119

    Article  CAS  Google Scholar 

  3. Neumeister VM, Anagnostou V, Siddiqui S, England AM, Zarrella ER, Vassilakopoulou M, Parisi F, Kluger Y, Hicks DG, Rimm DL (2012) Quantitative assessment of effect of preanalytic cold ischemic time on protein expression in breast cancer tissues. J Natl Cancer Inst 104:1815–1824

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  4. Khoury T, Sait S, Hwang H, Chandrasekhar R, Wilding G, Tan D, Kulkarni S (2009) Delay to formalin fixation effect on breast biomarkers. Mod Pathol 22:1457–1467

    Article  CAS  PubMed  Google Scholar 

  5. Moatamed NA, Nanjangud G, Pucci R, Lowe A, Shintaku IP, Shapourifar-Tehrani S, Rao N, Lu DY, Apple SK (2011) Effect of ischemic time, fixation time, and fixative type on HER2/neu immunohistochemical and fluorescence in situ hybridization results in breast cancer. Am J Clin Pathol 136(5):754–761

    Article  PubMed  Google Scholar 

  6. Tong LC, Nelson N, Tsourigiannis J, Mulligan AM (2011) The effect of prolonged fixation on the immunohistochemical evaluation of estrogen receptor, progesterone receptor, and HER2 expression in invasive breast cancer: a prospective study. Am J Surg Pathol 35:545–552

    Article  PubMed  Google Scholar 

  7. Khoury T (2012) Delay to formalin fixation alters morphology and immunohistochemistry for breast carcinoma. Appl Immunohistochem Mol Morphol 20:531–542

    Article  CAS  PubMed  Google Scholar 

  8. Yildiz-Aktas IZ, Dabbs DJ, Bhargava R (2012) The effect of cold ischemic time on the immunohistochemical evaluation of estrogen receptor, progesterone receptor, and HER2 expression in invasive breast carcinoma. Mod Pathol 25(8):1098–1105

    Article  CAS  PubMed  Google Scholar 

  9. Portier BP, Wang Z, Downs-Kelly E, Rowe JJ, Patil D, Lanigan C, Budd GT, Hicks DG, Rimm DL, Tubbs RR (2013) Delay to formalin fixation ‘cold ischemia time’: effect on ERBB2 detection by in-situ hybridization and immunohistochemistry. Mod Pathol 26(1):1–9

    Article  CAS  PubMed  Google Scholar 

  10. Li X, Deavers MT, Guo M, Liu P, Gong Y, Albarracin CT, Middleton LP, Huo L (2013) The effect of prolonged cold ischemia time on estrogen receptor immunohistochemistry in breast cancer. Mod Pathol 26:71–78

    Article  PubMed  Google Scholar 

  11. Goldstein NS, Ferkowicz M, Odish E, Mani A, Hastah F (2003) Minimum formalin fixation time for consistent estrogen receptor immunohistochemical staining of invasive breast carcinoma. Am J Clin Pathol 120:86–92

    Article  PubMed  Google Scholar 

  12. Oyama T, Ishikawa Y, Hayashi M, Arihiro K, Horiguchi J (2007) The effects of fixation, processing and evaluation criteria on immunohistochemical detection of hormone receptors in breast cancer. Breast Cancer 14:182–188

    Article  PubMed  Google Scholar 

  13. Kalkman S, Barentsz MW, Witkamp AJ, van der Wall E, Verkooijen HM, van Diest PJ (2014) Brief fixation does not affect assessment of hormone receptor expression in invasive breast carcinoma biopsies: paving the road for the same-day tissue diagnostics. Am J Surg Pathol 38:1071–8

    Google Scholar 

  14. Sujoy V, Nadji M, Morales AR (2014) Brief formalin fixation and rapid tissue processing do not affect the sensitivity of ER immunohistochemistry of breast core biopsies. Am J Clin Pathol 141(4):522–526

    Article  CAS  PubMed  Google Scholar 

  15. Kalkman S, Barentsz MW, van Diest PJ (2014) The effects of under 6 hours of formalin fixation on hormone receptor and HER2 expression in invasive breast cancer: a systematic review. Am J Clin Pathol 142(1):16–22

    Article  PubMed  Google Scholar 

  16. Wolff AC, Hammond ME, Schwartz JN, Hagerty KL, Allred DC, Cote RJ, Dowsett M, Fitzgibbons PL, Hanna WM, Langer A, McShane LM, Paik S, Pegram MD, Perez EA, Press MF, Rhodes A, Sturgeon C, Taube SE, Tubbs R, Vance GH, van de Vijver M, Wheeler TM, Hayes DF (2007) American Society of Clinical Oncology/College of American Pathologists guideline recommendations for human epidermal growth factor receptor 2 testing in breast cancer. J Clin Oncol 25(1):118–145

    Article  CAS  PubMed  Google Scholar 

  17. Wolff AC, Hammond ME, Hicks DG, Dowsett M, McShane LM, Allison KH, Allred DC, Bartlett JM, Bilous M, Fitzgibbons P, Hanna W, Jenkins RB, Mangu PB, Paik S, Perez EA, Press MF, Spears PA, Vance GH, Viale G, Hayes DF (2013) Recommendations for human epidermal growth factor receptor 2 testing in breast cancer: American Society of Clinical Oncology/College of American Pathologists clinical practice guideline update. J Clin Oncol 31(31):3997–4013

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Pathology, San Raffaele Scientific Institute, Università Vita-Salute San Raffaele, Milan, Italy

    Isabella Sassi, Francesca Invernizzi & Claudio Doglioni

Authors
  1. Isabella Sassi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Francesca Invernizzi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Claudio Doglioni
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Claudio Doglioni .

Editor information

Editors and Affiliations

  1. Institute of Pathology, Charité University Medicine, Berlin, Germany

    Manfred Dietel

  2. Institute of Pathology, University Hospital Leipzig, Leipzig, Sachsen, Germany

    Christian Wittekind

  3. University of Turin Institute of Pathology, Turin, Italy

    Gianni Bussolati

  4. Institute of Pathology, Charité University Medicine, Berlin, Germany

    Moritz von Winterfeld

Rights and permissions

Reprints and permissions

Copyright information

© 2015 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Sassi, I., Invernizzi, F., Doglioni, C. (2015). Short Formalin Fixation and Rapid Microwave Processing Do Not Affect HER2 Testing. In: Dietel, M., Wittekind, C., Bussolati, G., von Winterfeld, M. (eds) Pre-Analytics of Pathological Specimens in Oncology. Recent Results in Cancer Research, vol 199. Springer, Cham. https://doi.org/10.1007/978-3-319-13957-9_6

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-13957-9_6

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-13956-2

  • Online ISBN: 978-3-319-13957-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation