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Test Code 89027 Ki-67(MIB-1), Breast, Quantitative Immunohistochemistry, Automated

Reporting Name

Ki-67(MIB-1), Breast IHC, Automated

Useful For

Determining proliferation of tumor cells in paraffin-embedded tissue blocks from patients diagnosed with breast carcinoma

Performing Laboratory

Mayo Medical Laboratories in Rochester

Specimen Type

Varies

Specimen Required

Specimen Type:

Preferred: Formalin-fixed, paraffin-embedded tissue block containing invasive or metastatic breast carcinoma

Acceptable: 2 unstained sections, containing invasive or metastatic breast carcinoma, on charged slides cut at 4 microns <1 month ago. Tissue on the slides should have been fixed in 10% neutral buffered formalin.  

Container/Tube: Pathology Packaging Kit (Supply T554)

Collection Instructions:

1. Submit paraffin-embedded invasive or metastatic breast carcinoma tissue.

2. Include accompanying pathology report stating the final diagnosis. If not available, a preliminary diagnosis is acceptable only if it refers to invasive or metastatic breast carcinoma.

3. Attach the green pathology address label included in the kit to the outside of the transport container.

Additional Information:                         

1. Pathologist's name, address, and phone number are required.

2. Paraffin block will be returned with the final report.

3. Ki-67 immunohistochemistry testing on intracystic papillary carcinoma and solid papillary carcinoma, without clearly stating invasive carcinoma, is not appropriate and will be canceled without processing.

Forms:

1. Pathology/Cytology Information (T707) in Special Instructions

2. If not ordering electronically, complete, print, and send 1 of the following forms with the specimen:

Pathology Test Request Form (T246) (http://www.mayomedicallaboratories.com/it-mmfiles/pathology-request-form.pdf)

Oncology Test Request Form (T729) (http://www.mayomedicallaboratories.com/it-mmfiles/oncology-request-form.pdf)

Specimen Stability Information

Specimen Type Temperature Time
Varies Ambient (preferred)
  Refrigerated 

Reference Values

Varies by tumor type; values reported from 0% to 100%

Day(s) and Time(s) Performed

Monday through Friday; 8 a.m.-5 p.m.

Test Classification

This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the U.S. Food and Drug Administration.

CPT Code Information

88361

LOINC Code Information

Test ID Test Order Name Order LOINC Value
89027 Ki-67(MIB-1), Breast IHC, Automated In Process

 

Result ID Test Result Name Result LOINC Value
20279 Accession Number 57723-9
20280 Referring Pathologist/Physician 46608-6
20281 Ref Path/Phys Address 74221-3
20282 Material: In Process
20283 Tissue: 31208-2
20284 Interpretation: 69047-9
20285 Comment: 22638-1
20286 SP Signing Pathologist: 19139-5
20287 *Previous Report Follows* No LOINC Needed
20288 Addendum: 35265-8
20289 Addendum Comment: 22638-1
20290 Addendum Pathologist: 19139-5

Special Instructions

Testing Algorithm

If ordering for diagnostic purposes, order 70012 / Pathology Consultation and request the stain.

Method Name

Immunohistochemistry, Automated Quantitation