Important Note

Breast sample submitted to Pathology are time sensitive.

The D-H Laboratory is accredited by the College of American Pathologists (CAP).  The CAP requires that cold ischemic time be recorded for all breast pathology specimens.  Delays getting the tissue into formalin have adverse effects with the accuracy of predictive marker results. 

For fresh tissues:

• Submit specimen to the D-H Lab as soon as possible by courier or tube system (Note:  Larger specimens MUST be walked to the lab. Do not tube.) 
• If sending to Radiology first for imaging, ice the sample when in transit and submit to the lab as soon as possible after imaging. 
• The lab will record the cold ischemic time as the sample is triaged based on ‘time removed’ to ‘time placed in formalin’ by the lab.
• Ischemic times are recorded in the Surgical Pathology Report.

For tissues submitted in formalin:

• Record ischemic times via e-DH, by completing the question that prompts for time placed in formalin. 

For non e-DH users:

• Record the ischemic time on the multipart Surgical Pathology Requisition.  Record time removed and time placed in formalin.

For non-Lebanon sites:

Breast specimens may require ‘at the bedside’ triage to meet regulatory requirements. 

• Excisional biopsies/Partial mastectomies: After orienting and inking excisional biopsies, make 1-2 cuts to expose the lesion so that it comes in contact with formalin when placed in the specimen container.  Record time place in formalin.
• Mastectomies:  at the level of the lesion, make 1-2 cuts to expose the lesion so that it comes in contact with formalin when placed in the specimen container. Record time place in formalin.

DH Standard inking protocol for excisional biopsies:   

red (medial), yellow (lateral), orange (superior), green (inferior), black (posterior) and blue (anterior)