When submitting breast tissue pathology specimens removed for lesions clinically suspicious for malignancy, the cold ischemia time (removal of the tissue from the patient (TOC) and time placed in fixative (TIF)) must be included in the requisition form. The submitting facility must indicate the cold ischemia time under the "comments" section of the Epic Order. The cold ischemia time should not exceed 1 hour. Breast tissue that is examined at locations remote from the HFH main pathology lab must be bisected through the tumor upon removal to ensure fixation. Breast tissue specimens submitted for ER, PR, and HER2 testing should have a minimum of 6 and up to 72 hours of formalin fixation.
