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Test Code KIBM Ki67 Breast IHC Manual

Advisory Information

Ki-67 immunohistochemistry testing on intracystic papillary carcinoma and solid papillary carcinoma, without clearly stating invasive carcinoma, is not appropriate and will be canceled without processing.

Shipping Instructions

Attach the green pathology address label included in the kit to the outside of the transport container.

Necessary Information

1. Pathologist's name, address, and phone number are required.

2. Include accompanying pathology report stating the final diagnosis. If not available, a preliminary diagnosis is acceptable only if it refers to invasive or metastatic breast carcinoma.

Specimen Required

This is not an orderable test. Order PATHC / Pathology Consultation. The consultant will determine the need for special stains.


Supplies: Pathology Packaging Kit (T554)

Specimen Type:

Preferred: Formalin-fixed, paraffin-embedded tissue block containing invasive or metastatic breast carcinoma

Acceptable: 2 unstained sections, containing invasive or metastatic breast carcinoma, on charged slides cut at 4 microns <1 month ago. Tissue on the slides should have been fixed in 10% neutral buffered formalin.

Container/Tube: Pathology Packaging Kit (T554)

Collection Instructions: Submit paraffin-embedded invasive or metastatic breast carcinoma tissue.

Additional Information: Paraffin block will be returned with the final report.


1. Pathology/Cytology Information (T707) in Special Instructions

2. If not ordering electronically, complete, print, and send 1 of the following forms with the specimen:

Pathology Test Request Form (T246) (

Oncology Test Request Form (T729) (

Useful For

Determining proliferation of tumor cells in paraffin-embedded tissue blocks from patients diagnosed with breast carcinoma

Special Instructions

Method Name

Immunohistochemistry, Manual Semi-Quantitation

Reporting Name

Ki67 Breast IHC Manual

Specimen Type


Specimen Stability Information

Specimen Type Temperature Time
Special Ambient (preferred)

Reference Values

This is not an orderable test. Order PATHC / Pathology Consultation. The consultant will determine the need for special stains.


Varies by tumor type; values reported from 0% to 100%

Day(s) and Time(s) Performed

Monday through Friday; 8 a.m.-5 p.m.

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Test Classification

This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the U.S. Food and Drug Administration.

CPT Code Information


LOINC Code Information

Test ID Test Order Name Order LOINC Value
KIBM Ki67 Breast IHC Manual In Process


Result ID Test Result Name Result LOINC Value
71669 Interpretation 59465-5
71670 Participated in the Interpretation No LOINC Needed
71671 Report electronically signed by 19139-5
71672 Material Received 81178-6
MA035 Tumor type 44638-5
MA036 Tumor classification 21918-8
71673 Disclaimer 62364-5
71844 Case Number 80398-1