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.
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References
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
Allison M (2010) The HER2 conundrum. Nat Biotechnol 28(2):117–119
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
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
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
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
Khoury T (2012) Delay to formalin fixation alters morphology and immunohistochemistry for breast carcinoma. Appl Immunohistochem Mol Morphol 20:531–542
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
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
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
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
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
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
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
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
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
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
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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
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DOI: https://doi.org/10.1007/978-3-319-13957-9_6
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