Implementation of immunohistochemical staining among mohs micrographic surgeons

Abstract Background Immunohistochemical staining has been used as part of Mohs micrographic surgery (MMS) to improve sensitivity for the detection of subtle residual tumors. It is typically used in the histopathologic detection of tumors such as malignant melanoma, extramammary Paget disease, and po...

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Main Authors: Samantha K. Sarlin, Kourosh Beroukhim, Isadore Tarantino, Leonard H. Goldberg, Arash Kimyai‐Asadi
Format: Article
Language:English
Published: Wiley 2022-06-01
Series:JEADV Clinical Practice
Subjects:
Online Access:https://doi.org/10.1002/jvc2.21
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author Samantha K. Sarlin
Kourosh Beroukhim
Isadore Tarantino
Leonard H. Goldberg
Arash Kimyai‐Asadi
author_facet Samantha K. Sarlin
Kourosh Beroukhim
Isadore Tarantino
Leonard H. Goldberg
Arash Kimyai‐Asadi
author_sort Samantha K. Sarlin
collection DOAJ
description Abstract Background Immunohistochemical staining has been used as part of Mohs micrographic surgery (MMS) to improve sensitivity for the detection of subtle residual tumors. It is typically used in the histopathologic detection of tumors such as malignant melanoma, extramammary Paget disease, and poorly differentiated and spindle cell neoplasms. Materials and Methods The study involved a questionnaire link emailed by the American College of Mohs Surgery to its members. The survey sought demographic information and asked about the use of immunohistochemistry (IHC) stains during fellowship training and in current practice as well as reasons why IHC staining is not incorporated into certain practices. The data were tabulated and analyzed. Results A total of 84 surveys were completed. Of these, 30 (35.7%) indicated having received training in IHC during the fellowship, whereas 54 (64.3%) did not. Currently, 32 (38.1%) respondents utilize IHC in their practice, whereas 52 (61.9%) do not. Among those who trained in IHC during the fellowship, 60% (n = 18) continue to utilize IHC, whereas among those whose fellowship did not incorporate IHC, 74.1% (n = 40) do not utilize IHC. A number of different immunostains were reportedly utilized during fellowship and in current practice. Among those not utilizing IHC, the top reasons cited were lack of sufficient volume to justify use (n = 38, 70.3%), cost of implementation (n = 38, 70.3%), the stains being time‐consuming (n = 36, 66.7%), and lack of familiarity with reading immunohistochemical stains (n = 29, 53.7%). Conclusions The use of IHC among Mohs surgeons appears to be rising compared to previous historical studies, but significant barriers remain to widespread implementation.
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spelling doaj.art-693e79bd53ea4bb4b06b2cae7ed0b6372022-12-22T02:30:52ZengWileyJEADV Clinical Practice2768-65662022-06-011212612810.1002/jvc2.21Implementation of immunohistochemical staining among mohs micrographic surgeonsSamantha K. Sarlin0Kourosh Beroukhim1Isadore Tarantino2Leonard H. Goldberg3Arash Kimyai‐Asadi4DermSurgery Associates Houston Texas USADepartment of Medicine, Division of Dermatology Houston Methodist Hospital Houston Texas USADepartment of Medicine, Division of Dermatology Houston Methodist Hospital Houston Texas USADermSurgery Associates Houston Texas USADermSurgery Associates Houston Texas USAAbstract Background Immunohistochemical staining has been used as part of Mohs micrographic surgery (MMS) to improve sensitivity for the detection of subtle residual tumors. It is typically used in the histopathologic detection of tumors such as malignant melanoma, extramammary Paget disease, and poorly differentiated and spindle cell neoplasms. Materials and Methods The study involved a questionnaire link emailed by the American College of Mohs Surgery to its members. The survey sought demographic information and asked about the use of immunohistochemistry (IHC) stains during fellowship training and in current practice as well as reasons why IHC staining is not incorporated into certain practices. The data were tabulated and analyzed. Results A total of 84 surveys were completed. Of these, 30 (35.7%) indicated having received training in IHC during the fellowship, whereas 54 (64.3%) did not. Currently, 32 (38.1%) respondents utilize IHC in their practice, whereas 52 (61.9%) do not. Among those who trained in IHC during the fellowship, 60% (n = 18) continue to utilize IHC, whereas among those whose fellowship did not incorporate IHC, 74.1% (n = 40) do not utilize IHC. A number of different immunostains were reportedly utilized during fellowship and in current practice. Among those not utilizing IHC, the top reasons cited were lack of sufficient volume to justify use (n = 38, 70.3%), cost of implementation (n = 38, 70.3%), the stains being time‐consuming (n = 36, 66.7%), and lack of familiarity with reading immunohistochemical stains (n = 29, 53.7%). Conclusions The use of IHC among Mohs surgeons appears to be rising compared to previous historical studies, but significant barriers remain to widespread implementation.https://doi.org/10.1002/jvc2.21dermatopathologyimmunohistochemistrymelanomaMohs surgery
spellingShingle Samantha K. Sarlin
Kourosh Beroukhim
Isadore Tarantino
Leonard H. Goldberg
Arash Kimyai‐Asadi
Implementation of immunohistochemical staining among mohs micrographic surgeons
JEADV Clinical Practice
dermatopathology
immunohistochemistry
melanoma
Mohs surgery
title Implementation of immunohistochemical staining among mohs micrographic surgeons
title_full Implementation of immunohistochemical staining among mohs micrographic surgeons
title_fullStr Implementation of immunohistochemical staining among mohs micrographic surgeons
title_full_unstemmed Implementation of immunohistochemical staining among mohs micrographic surgeons
title_short Implementation of immunohistochemical staining among mohs micrographic surgeons
title_sort implementation of immunohistochemical staining among mohs micrographic surgeons
topic dermatopathology
immunohistochemistry
melanoma
Mohs surgery
url https://doi.org/10.1002/jvc2.21
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AT isadoretarantino implementationofimmunohistochemicalstainingamongmohsmicrographicsurgeons
AT leonardhgoldberg implementationofimmunohistochemicalstainingamongmohsmicrographicsurgeons
AT arashkimyaiasadi implementationofimmunohistochemicalstainingamongmohsmicrographicsurgeons