“If you think of standardization as the best that you know today, but which is to be improved tomorrow, you get somewhere.” – Henry Ford

The first step of Standardization in Histology, not just in a single lab, was taken when it was decided to use one fixative for routine specimens, 10% Neutral Buffered Formalin (NBF). Now we all know that there are other fixatives for special procedures and tissue types and we use them accordingly, but overall, 10% NBF is the standard fixative for routine tissue samples. Who made that decision? Look what standardization of tissue sampling has done for Cytotechnology. The Pap smear and the fine needle aspiration used to be “smeared” on a slide and the quality of the sample and the technologist review time varied greatly from sample to sample. The development of single layer, liquid preparation provided a consistent sample that can now be screened by image analysis, resulting in greatly improved quality, reduced review time and improved patient care. So, why did this process change catch on so fast? The Pathologists were the driving force behind this improvement and demand for improved quality.

Why are the Pathologists and their surrogates, the Pathology Assistant, not championing standardization of Surgical Pathology tissue samples? Is it so unthinkable to use a set of tools that assist in attaining the precise sample? Isn’t it obvious that standardized sample size and thickness will control fixation, reduce processing time, optimize automation and improve the quality of stained tissue samples? Is it worth spending a small increase in time at the grossing bench to realize exponential gains, improvements and cost reduction in the remaining technical tasks in the Histology process? What can we do to convince the Pathologists and the Pathology Assistants that we must partner together to change and standardize tissue sampling?