Your Biopsy Lives On-What Happens After the Diagnosis is Made

blocks-in-storage

Biopsy blocks are stored for 10 years. Current regulations also require additional identifying information such as patient name.

So we have made your diagnosis. Hopefully, your biopsy was benign, but what if it was malignant? What happens next? What does a lab do with any leftover bits of your tissue?  What happens to the glass slides we looked at under the microscope to make the diagnosis? While I will use the prostate biopsies that we see in our lab as an example, much of this can be extrapolated to other biopsies, such as those from the breast, lung or colon.

Let’s talk about the “left-over” tissue first. With prostate biopsies, all the tissue is processed; that is to say that all of the biopsy material has been dehydrated, rehydrated and embedded in paraffin wax. The diagnostic slides were made from these paraffin blocks, but not all the tissue in the blocks is used up. What happens to the remainder? Sometimes nothing, but sometimes a lot. And more and more is being done with each passing year.

In cancer cases, we use that extra tissue to verify that the specimen we just made the diagnosis on is from the right patient. That’s a no-brainer you say, but we want to do everything we can to ensure that the Mr. Bowl’s cancer didn’t inadvertently get transferred to Mr. Plate’s specimens. So we work with a company that does a DNA double check. The company compares the DNA in Mr. Bowl’s biopsy core to the DNA in cells on a cotton swab that was rubbed against the inside of Mr. Bowl’s cheek when he was in the doctor’s office for the biopsy. The DNA results should be the same. It’s a high tech version of “The Match Game,” and creates a sense of confidence for patient, urologist, and pathologist.

The tissue in the paraffin block has other valuable uses. An increasing number of analyses can be done to determine the aggressiveness of the cancer, usually by using DNA testing to evaluate what genes have been altered in the tumor. There are even tests that look at benign biopsies and “predict” the likelihood of cancer being diagnosed in the next two years.

The glass slides have use as well. We can send them to another pathologist for a second opinion. They can be run through a device which creates a totally digital replica of the slide that can be viewed anywhere around the world. And they can be reevaluated as part of research studies.

How long do we retain the blocks and slides? We follow our accreditation regulations and local/federal laws and dispose of this material after 10 years. Space requirements make maintaining the material for longer than a decade prohibitive. While it would seem valuable to use this older material in research rather than dispose of it, investigation with some of our research partners has indicated the 10-year-old material has degenerated and is not suitable for the studies currently being done on newer material.

One more thing; most pathologists would be glad, and often eager, to show you your slides under the microscope. Usually a phone call is all it takes to make the arrangements. Don’t be shy, it is YOUR health!

And on a closing note–HAPPY LAB WEEK TO ALL MY LAB PARTNERS. Your pride and dedication in your work makes us an outstanding laboratory.

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The above is the opinion of the author and not of UroPartners, LLC.

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