Authors Talk “Truth” in Tissue Samples

It’s incredible to think that years of scientific research might’ve been conducted with tissue samples that were nearly worthless—but that frustrating reality is what keeps David Hicks, M.D., and other progressive pathologists pushing for improvements.

Hicks is a breast cancer specialist and director of Surgical Pathology at URMC and the Wilmot Cancer Institute. He was asked about some of pathology’s dark secrets of the past in a recent interview with Richard Harris, an award-winning science correspondent at NPR.

Harris is on leave from NPR to write a book about reproducibility in biomedical research and why results from some laboratories cannot be repeated elsewhere.

Tissue sample handling could be one major culprit. If a tumor sat on a table in the back of an operating room for more than an hour, for example, and then not transported or fixed properly, the results of the tests on that tumor would be questionable, Hicks said. Tissue that sits outside the body is deprived of oxygen and begins to degrade rather quickly.

The bulk of Hicks’ career has been dedicated to improving tissue-handling systems so that patients can get a proper diagnosis and researchers can get reliable results. In 2010 Hicks served on an international panel concluding that inconsistent pathology lab practices led to dubious test results in 20 percent of cases. (The tests were looking for estrogen and progesterone biomarkers in breast cancer, information that’s crucial to treatment decisions.)

The panel’s discovery prompted new standards, guidelines and training for pathologists. And last month Hicks published his own book, “Diagnostic Pathology, Breast, second edition,” with co-author Susan C. Lester, M.D., Ph.D., of the Dana Farber Cancer Institute. The book includes many high-quality images from the UR Medicine Pathology Lab.

“If we have quality samples, the right tools, and well-trained pathologists—that’s when we get closer to the truth,” Hicks said.