biology

SEE-FIM Protocol

SEE-FIM Protocol is a biology topic covered in the lgStudy science library. This page brings together a partial reference excerpt, illustrations, worked examples, real-world applications and a short study plan, so you can understand SEE-FIM Protocol rather than just read about it. In short: The SEE-FIM protocol is a pathology dissection protocol for Sectioning and Extensively Examining the Fimbria (SEE-FIM). This protocol is intended to provide for the optimal microscopic examination of the distal fallopian tube (fimbria) to identify either cancerous or precancerous conditions in this organ.

Key takeaways

SEE-FIM Protocol belongs to biology; place it in that map before memorising details.
Learn the definition first, then one example that makes the definition concrete.
Connect SEE-FIM Protocol to a quantity you can measure, compute or draw — that is where exam questions come from.
Reproduce the core statement of SEE-FIM Protocol from memory before moving on to harder problems.

Reference excerpt

The SEE-FIM protocol is a pathology dissection protocol for Sectioning and Extensively Examining the Fimbria (SEE-FIM). This protocol is intended to provide for the optimal microscopic examination of the distal fallopian tube (fimbria) to identify either cancerous or precancerous conditions in this organ.

Background Women with either a strong family history of breast and ovarian cancer or a documented inherited (germline) mutation in a BRCA gene are encouraged to consider risk reduction salpingo-oophorectomy (RRSO). The surgery is ideally conducted prior to the time that the risk of developing HGSC became too great to defer the procedure, which was age 35 for women with BRCA1 and 45 for BRCA2 mutations. Removal of both tubes and ovaries has reduced the risk of subsequent HGSC by 85% [see BRCA mutation]. Beginning in 2000, pathologists began to encounter early, often non-invasive HGSCs (serous tubal intraepithelial carcinomas or STICs) in the fallopian tubes of women with germ line BRCA mutation who underwent RRSO.

Introduction of the SEE-FIM protocol

Conception The SEE-FIM protocol was introduced in 2005 and required examining all of the fallopian tube, specifically the sectioning and examination of the distal one-third (infundibulum and fimbria). Early HGSCs of the fallopian tube, once considered rare, were encountered frequently in this portion of the tube once the SEE-FIM protocol was adopted. Based on this information, the distal fallopian tube was cited as an origin for many HGSCs formerly classified as ovarian cancers. The SEE-FIM protocol was adopted by many to identify or exclude these tumors during pathologic examination of the fallopian tubes in risk reduction salpingo-oophorectomies.

Method The SEE-FIM protocol consists of five steps (See Figure):

The tube is fixed for at least 2 hours in laboratory fixative. The distal one third is amputated. The distal one third is sectioned in the longitudinal (sagittal) plane as thinly as possible and submitted for processing. The remainder of the tube is sectioned in the transverse (cross section) plane every 1-2 millimeters and submitted for processing. Sections are stained with hematoxylin and eosin and are examined by the pathologist with attention to the epithelial cells and the presence of any evidence of a malignancy or precancerous condition.

Acceptance in pathology practice

As of 2018, the SEE-FIM protocol was being used by 85% of academic pathology practices and 65% of private practices in the United States and elsewhere in the World. Routine use of the SEE-FIM protocol has been recommended by the College of American Pathologists and the International Society of Gynecologic Pathologists when processing fallopian tubes in risk reduction surgeries, and cases of ovarian and uterine serous cancer. It is also recommended in the reporting guidelines for gynecologic cancer sponsored by the British Gynecologic Cancer Society. It is also part of routine protocols in academic institutions and was employed to ascertain the frequency of STIC in a large population-based study.

Indications for the Protocol The primary purpose of the SEE-FIM protocol is to detect small cancers in the fallopian tube that are not visible to the naked eye. It is used most often in the following scenarios.

Prophylactic salpingectomy In RRSO specimens from healthy women at increased risk for HGSC, the protocol is used to confirm or exclude the presence of an early HGSC (STIC). If a malignancy is discovered there is a significant risk of a later recurrence, computed at 10% and 27% at 5 and 10 years. In contrast, if no abnormality is found the risk is less than 1%.

Opportunistic salpingectomy This procedure has been introduced to remove the fallopian tubes when convenient after the cessation of childbearing. The protocol is used to exclude occult cancer. A recent study of over 25,000 women who underwent this procedure reported no cases of HGSC in follow-up if no cancer was found.[see Prophylactic salpingectomy].

Surgical excision specimens from women with HGSC In cases with advanced HGSC, the SEE-FIM protocol provides a detailed assessment of the fallopian tube to determine if the tumor arose in the fallopian tube. If pathologic examination confirmed the presence of HGSC in the tubal epithelium, the tumor would be classified as a primary fallopian tube malignancy. This information is also helpful in ascertaining the extent (or stage) of tumor involvement, which in turn influences choice of therapy. .

See also High grade serous carcinoma BRCA mutation Fallopian tube cancer Ovarian cancer Ovarian Cancer Research Alliance Prophylactic salpingectomy

Abbreviations BRCA – Breast cancer associated tumor suppressor genes, including BRCA1 and BRCA2. Inherited (germline) loss of a BRCA gene imposes an increased risk of breast and ovarian cancer. TP53 – A tumor suppressor gene that is mutated in High grade serous carcinoma. RRSO – Risk reduction salpingo-oophorectomy. RRS – Risk reduction salpingectomy. HGSC – Extrauterine high grade serous carcinoma. STIC – Serous tubal intraepithelial carcinoma, a non-invasive precursor to high grade serous carcinoma

References

Illustrations

Worked examples

Example 1 — a first encounter with SEE-FIM Protocol

Start with the simplest possible case. Write down what SEE-FIM Protocol claims or describes in one sentence, then invent the smallest concrete situation in which that sentence is true. In biology, the smallest case is usually a single object, a single equation or a single measurement. Check that every symbol or term in your sentence has a meaning in that case.

Example 2 — changing one variable

Take the situation from Example 1 and change exactly one quantity: double it, halve it, or set it to zero. Predict what should happen to SEE-FIM Protocol before you calculate. Comparing your prediction with the result is the fastest way to find out whether you understand the idea or only the words.

Example 3 — an exam-style question

Typical questions about SEE-FIM Protocol ask you to (a) state it precisely, (b) apply it to given data, and (c) explain a limitation. Practise writing all three answers in under five minutes; the third part is what separates a full-mark answer from an average one.

Applications of SEE-FIM Protocol

In research: SEE-FIM Protocol appears in biology research whenever the underlying quantities have to be modelled precisely. Papers usually cite it as a starting assumption and then explore where it breaks down.
In technology and industry: Engineering practice reuses SEE-FIM Protocol in design rules, simulations and safety margins. Knowing the idea lets you read a specification sheet and understand why the numbers look the way they do.
In the classroom: SEE-FIM Protocol is common in secondary-school and first-year university syllabi. It links to neighbouring topics Cancer pathology, Diagnostic obstetrics and gynaecology, Medical guidelines, so understanding it makes those chapters shorter.
In everyday life: Look for SEE-FIM Protocol outside the textbook — in sport, cooking, traffic, electronics or the sky above you. An example you found yourself is remembered far longer than one you were given.

Affiliate

Preply — study more efficiently by working with a personal tutor. 50% off.

How to study SEE-FIM Protocol in 20 minutes

Read the reference excerpt below once, without taking notes.
Close the page and write down what SEE-FIM Protocol means in your own words.
Compare your version with the excerpt and mark what you missed.
Work through the three examples above with pen and paper.
Explain SEE-FIM Protocol out loud to somebody else — or to Teacher Smith in the lgStudy chat.

Frequently asked questions

What is SEE-FIM Protocol in simple terms?

Why does SEE-FIM Protocol matter?

Because it connects several biology ideas at once: it gives you a definition you can apply, a quantity you can calculate, and a way to check whether a result is plausible.

How should I study SEE-FIM Protocol?

Read the excerpt, restate it from memory, then work through the examples and applications listed on this page. The five-step study plan above takes about twenty minutes.

What does this page cover?

It gives you a compact reference excerpt plus original lgStudy explanations, examples, applications and study material on SEE-FIM Protocol.