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To improve accuracy of the immunohistochemical testing and fluorescence in situ hybridization (FISH) study as well as a routine histology diagnosis in breast cancer, quality improvement for optimal tissue handling is mandatory. We evaluate fraction defective of 7107 blocks from 349 breast cancer patients, who underwent surgical treatment at Samsung Medical Center Seoul, Korea from January 1, 2009 to March 31, 2010. We decided pre-improvement period from January, 2009 to June, 2009. In the first quality improvement period (July, 2009 to September, 2009) we made improvements in protocol of gross examination. In the second quality improvement period (October, 2009 to December, 2009) we attempted more effective formalin fixation such as frequent exchange of formalin and use of separate fixation container for each case. In the third quality improvement period (January, 2010 to March, 2010) improvement of tissue processor was performed. We achieved a marked reduction of fraction defective (9-16%) through efforts to improve quality of formalin-fixed, paraffin-embedded blocks when compared to pre-improvement period.



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Breast cancer, Fixation, quality improvement