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“Oncology like a lot of samples”

11 replies

MrsMikeHeck · 29/01/2023 17:16

I had biopsy after breast ultrasound. After the first sample was collected, I asked if there would be more. The doctor said she was taking three as oncology like lots of samples.

The biopsy was last Monday. I have an appointment tomorrow. I know I just have to wait it out but I wondered whether all biopsy samples automatically go to oncology?

Any information would be really appreciated.

OP posts:
MrsPelligrinoPetrichor · 29/01/2023 17:25

I think so, I was under the impression they test all biopsies. Best of luck for tomorrow, I'm also waiting for results and the wait is agonising isn't it?x

MrsMikeHeck · 29/01/2023 17:43

I think I assumed the biopsies went to a general lab rather than oncology. Obvs, I know nothing of how hospitals work Smile

when was your biopsy?

OP posts:
gmailconfusion2 · 29/01/2023 18:04

Most biopsies of tissue go to a general Histology lab, there may be a few occasions where it will go directly to a specialist centre, such as IMF samples on skin, or in cases where lymphoma is suspected where the cells are studied, if you had a fluid sample taken, of say a cyst, fluid from your abdomen or chest, or knee joint where they are not querying an infection, it will go to cytology. If it is a fluid questioning an infection it should go to microbiology.

Your biopsies will have been placed in a fluid called formlin and allowed fix' for a minimum of 8 hours, before being described by a biomedical scientist, and then processed. Processing normally takes 13+ hours, and during it the water in your tissue is removed and replaced with wax. Once this is complete the tissue is placed into a wax block, cut, stained and given to a histopathologist. Who will look at it and ask for further stains (add another day) before reporting. If her2 testing isn't carried out in house the block will be sent away for staining before the slide is returned and viewed by the pathologist.

Generally labs say 7 working days to get a result, nothing about histology is fast. we can normally get breast cores on thursday, process friday night, cut and stain monday morning, pathologists look monday lunch or afternoon, ihc requests by 3:30 and have those stained for the MDT at 12 tuesday, but it's tight.

We like adequate biopsies, because if the first core missing the tumour you have gone through that for nothing and it will need to be repeated, we can do nothing about a diagnosis if we do not have the abnormal cells to look at. Also if there is not enough tissue (lung biospsies are the worst) we can't do all the testing and so the results will be incompleted and further tissue requested, especially in the era of genetic testing.

MrsMikeHeck · 29/01/2023 18:32

@gmailconfusion2 that is really interesting, thank you very much.

it’s also calmed my nerves a bit. I had biopsy 930 Monday morning, and received a message Tuesday 3.50pm with an appointment for the following morning. I assumed the worst - that they had the results on Tuesday so were acting ad quick as possible. But it sounds like they wouldn’t have had the results 36hours after collection?

OP posts:
gmailconfusion2 · 29/01/2023 18:45

@MrsMikeHeck I would be very very surprised if they had a result tuesday afternoon, its probably a reflex appointment, you had a biopsy so you automatically get a follow up.

We can see a core is malignant at dissection, however we can't say what hormone receptors are present, and its these that are most important. These are what determines a treatment plan.

Assuming the lab put it on the same days(monday) as it was an early appointment, lab opens at Tuesday 9 (very common) you would assume it was hopefully embedded in wax before ten, cut before 11, stained before 12 with a H&E stain. Then the pathologist has to look at the stains and send down a request, so possibly 1 but normally ours seem to look through a batch of stuff before bringing it down so realistically it takes longer, you then have to have time to look at the requests, find the blocks, cut the slides to be stained, dry and then bake for at least 30min, so they wouldn't be on before 2 most likely, and our progesterone and oestrogen stains both take over 2 hours, then you have to cover slip them and give them to the pathologists. This is assuming there is space on the machine, everything is really efficient, and the consultants aren't doing anything else.

All breast cases everywhere I have worked are treated as urgent, they always try to get the results through for the first MDT that comes up, as they know it is incredibly concerning for the woman involved.

Redannie118 · 29/01/2023 18:53

Hi op good luck for tomorrow first of all.

When i was diagnosed they knew it was cancer from the mamogram and ultrasound. The biopsy was to check stage/type ect and I was told that was the case during the app. Ive heard from lots of other breast cancer patients this was also the case with them.

If you do need additional support after tomorrow, the cancer board on here is amazing.

Please let us know how you get on.

gmailconfusion2 · 29/01/2023 21:33

@Redannie118 we also get them when the scan is unclear, so R3. R1/2 being benign, R4/5 suspicious of or malignant.

OP I hope it comes back clear for you, if you are uncertain of anything they say, do ask.

MrsMikeHeck · 29/01/2023 22:24

Thank you both.

Todays gone quicker than the other days. Appointment is at 10am, even if I wake up really early, I think I can’t have more than 7 waking hours of not knowing.

OP posts:
Redannie118 · 31/01/2023 15:31

@MrsMikeHeck how did you get on?

MrsMikeHeck · 31/01/2023 16:45

I got the date wrong - it’s next Monday!

OP posts:
Redannie118 · 31/01/2023 16:53

Oh no ! Sorry you will have to wait so long!

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