Preparing pathology for personalized medicine: possibilities for improvement of the pre-analytical phase

With the introduction of new biological agents for cancer treatment enabling 'personalized medicine', treatment decisions based on the molecular features of the tumour are more common. Consequently, tissue evaluation in tumour pathology is becoming increasingly based on a combination of classical morphological and molecular analysis. The results of diagnostic tests rely not only on the quality of the method used but, to a large extent, also on the quality of specimens, which is dependent on the pre-analytical procedures and storage. With the introduction of predictive immunohistochemical and molecular tests in clinical pathology, improvement and standardization of pre-analytical procedures has become crucial. The aim of this review is to increase awareness with regard to tissue handling and for standardization of the pre-analytical phase of a diagnostic process. In addition, several processing steps in tissue handling that need to be improved in order to obtain the quality needed for modern molecular medicine will be discussed. Optimal, standardized procedures are crucial if a high standard of test results is to be achieved, which is what each patient deserves.