Cutting Techniques

• After orientation of a specimen, section any shave margins first if needed.  Place the specimen on the cutting surface and section the tissue on the short axis, unless otherwise necessary.
• Use a blade that is 1-1/2 to 2 times greater than the axis to be sectioned.  The length of the blade should pass over the tissue without the blade edge and handle "punching” the tissue.  Do not use a blade that is too short to make one slice across the entire surface.  If it is too short, the tissue will appear serrated and jagged because the back of the blade and the handle is tearing the tissue.
• Point the tip of the blade slightly downward to reduce the surface area.  Maintain the integrity of the specimen to reapproximate for further examination, if necessary.
• If the integrity cannot be maintained after serial sectioning, arrange the remaining specimen in such a way to keep the order of sections.  Use a paper towel to mark the orientation or order as a clue or reminder at the time of further exam.   
• Sections must be no greater than 0.5 cm thickness/section on large specimens (mastectomies, liver, and lung).  This will show more cut surfaces for thorough inspection.  You may have to further dissect the 0.5 cm section if searching for small biopsy sites or very small nodules.   If you have not visually identified pathology, palpate the 0.5 cm sections for clues.  When searching for small biopsy sites/pathology, use the information in Careweb to assist in the location.
• When serially sectioning a specimen, section to within 0.3 cm of the cutting surface.  This will leave a thin segment to help retain the integrity of the specimen.  As you choose to take histology sections, use other areas to demonstrate pathology if possible.  You do not have to separate the entire section from the remaining specimen.
• Use the forceps or your fingers to keep the tissue stable when you cut thin sections.  Grasp the tissue with the tips of the forceps but do not squeeze the tissue.  Try to keep a distance between the blade and your fingers of the non-cutting hand to avoid stabbing or slicing that hand/finger.
• Use sharp blades at all times.  Cutting/stabbing injuries happen most when trying to section with a dull blade.  Change your blades frequently to keep a sharp edge.
• When using the scissors keep the tissue near the tips and do not clog them with too much tissue.  Try to avoid using scissors for the histology sections, as this may show crush artifact.
• Scissors may be used to trim the tissue.  This should only be done after the tissue is placed in the cassette and the excess thickness can be cut with scissors to fit the lid on the cassette.  
• With loose/mobile tissue (lung, breast) start the section with a fast, light slicing motion and once the sharp blade begins cutting through the layers then slow the slicing motion and apply more pressure on the handle toward the cutting surface.
• Avoid pressing the blade handle to the cutting surface until the blade has begun to cut into the tissue to minimize crushing the tissue and bending the blade handle.
• If the tissue needs to be laid flat on the cutting surface, put your non-cutting hand on top of the tissue with your palm flat.  Apply a slight pressure to stabilize the tissue and section it horizontally.
• If the specimen has been inked, dry the inked surface(s) as much as possible before sectioning.   
• Take sections for histology that will show transition of normal to tumor, tumor to an anatomic marker and/or representative tissue to an inked margin.