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Histopathology tissue specimens in paraffin
Lost tissue samples in labs can lead to problems for patients, such as additional biopsies.
iStock, Md Ariful Islam

How Many Lost Tissue Samples Has Your Anatomic Pathology Lab Endured?

Technology can help avoid this perennial problem for clinical laboratory managers

Denise Bland

Denise Bland, MHA, HTL(ASCP)QIHC, has been involved in clinical diagnostics for over 30 years, including molecular pathology, histopathology, tissue banking, clinical trials, and beyond. She is currently the senior administrative director for pathology and laboratory medicine at a leading academic medical center in Boston.

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Published:Aug 26, 2024
|2 min read
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The problem of lost tissue samples has been an issue for anatomic pathology (AP) labs for decades. Innovations over time brought us laboratory information systems, barcoding of samples, and other technologies that have improved sample chain-of-custody. 

However, the problem of misplaced, and even completely lost, tissue samples has persisted. Every AP lab manager has had the unfortunate experience of deploying a search party of lab techs and assistants to find a missing block or slide. In most cases, the missing sample is recovered. 

However, if there is even one missing sample not recovered, it’s one too many, and patient care suffers. There is automation technology that can ease the problem of lost samples, and AP laboratories should investigate it.

Lost tissue samples lead to patient troubles

Lost samples happen more often than anyone wants to admit or discuss. As custodians of these assets, we have an obligation to do better. Everyone wants to avoid:

  • Re-biopsy. This is physically and emotionally painful for the patient, and there may be the risk that the only positive tissue samples have already been excised from the patient. Re-biopsy is also costly for the hospital or laboratory. Biopsies can cost from hundreds of dollars for a routine needle biopsy to thousands of dollars for more complex surgical biopsies.
  • The potential of undergoing unnecessary or ineffective treatments. When a tissue sample is lost, proper reflex testing may not be possible to qualify patients for precision therapies.
  • Failure to gain access to clinical trials. The usual minimum requirement for a patient to be enrolled in a clinical trial is two unstained slides. When a tissue sample is lost, patients may be unable to qualify for clinical trials that could be their best option.

Solutions to solve the problem of lost tissue samples (blocks and slides) are available. 

Automation Can Curb Sample Loss

The ideal solution offers multiple systems that address common areas where samples can be misplaced or lost, including pre- and post-tissue processing, tissue block archiving and retrieval, and slide archiving and retrieval. This technology has been available for approximately 10 years; however, many labs are still not aware of available automated options to prevent lost samples.

All AP labs will benefit from addressing the issue of lost tissue samples, regardless of their size or case volumes. As cancer incidence rates rise and the availability of qualified laboratory staff declines, greater care must be paid toward managing tissue samples. 

Further, relieving lab staff from the mundane activities of manually sorting and organizing tissue samples is important to keep pace with the increasing demand for diagnostic testing and treatment.