Re: [Histonet] Uneven ER/PR
Joanne, I do not think you should expect to get perfectly uniform IHC staining in breast core biopsies every time. At our hospital, we prefer to avoid doing hormone receptor stains on breast cores because they are not as "robust" as a lumpectomy or mastectomy specimen. The unevenness could be due to pre-analytic causes beyond your control (such as: are they placed in directly and immediately into formalin by the radiologist? Is your processing schedule optimized for small biopsies or is it a "one-size fits all" schedule for large and small specimens, etc). Occasionally, we will agree to an Oncology request to stain them but this is usually only done when they feel it is not going to be clinically beneficial to put the patient through a more invasive procedure (ie lumpectomy). Another disadvantage of looking at cores vs lump specimens is that you cannot see the "bigger picture". Perhaps there is heterogeneity in the intensity of the ER/PR expression throughout the tumor; something that is easier to discern when you can see the staining pattern across the entire cross-section of the tumor. I too use the Bond platform. If you are placing appropriate tissue controls on the same slide as the patient and these have the expected staining pattern and intensity, you may be fairly certain that the issue was (or is) pre-analytic in nature. If this is not your practice, then try re-staining new sections of the same case. If it is corrected, contact Leica Tech support to try to figure out what went wrong the first time. If it is not corrected, then you are back to suspecting a pre-analytic issue (assuming you are not seeing this uneven-ness in other IHC specimens). I strongly encourage use of tissue controls on every patient slide. Cheers, Greg -- *Greg Dobbin* 1205 Pleasant Grove Rd RR#2 York, PE C0A 1P0 *Everything in moderation...even moderation itself**!* ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
Re: [Histonet] Uneven ER/PR
My first 2 items to check whenever I have uneven IHC staining are (1) Inadequate deparaffinization, (2) bad lot of charged slides - yes this can cause terribly streaky or spotty staining, and since you are using the Bond, perhaps there was an issue with coverplate placements. Just things to consider. Hope this helps, Terri Terri L. Braud, HT(ASCP) Anatomic Pathology Supervisor Laboratory Holy Redeemer Hospital 1648 Huntingdon Pike Meadowbrook, PA 19046 ph: 215-938-3689 fax: 215-938-3874 Today's Topics: 2. ER/PR Uneven Staining (Joanne Clark) Message: 2 Date: Tue, 29 Nov 2016 21:09:17 + From: Joanne Clark Subject: [Histonet] ER/PR Uneven Staining I had a breast needle core today that when stained with ER and PR the staining was uneven throughout the core, even though the cancer cells were present in the entire core. The specimen had 10 hours fixation in 10% NBF. I could understand the uneven staining from inadequate fixation on large grossed in breast tissue, but 10 hours with needle core biopsies has always been more than sufficient. Does anyone have any ideas? We use Leica's ER and PR antibodies on the BOND. Joanne Clark, BAAS, HT(ASCP)CM Director of Histology ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
