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Findings show good diagnostic performance for HER2-low, high specificity and PPV, with ROC AUC supporting clinical reliability when tissue is limited or 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detection?",{"text":72,"@type":64},"ICC on FNAC-derived CBs showed good diagnostic performance, with sensitivity in the mid-to-high 50% range, high specificity (about 86%–93%), PPV around 90%–95%, and concordance above 90% with ROC AUC values of roughly 0.71–0.76.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},352495,1790462292,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,106,110,115,120,123,126],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & 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detecting HER2-low status in FNA of primary and metastatic breast cancer  \nGiuseppe D’Abbronzo MD1,2 | Stefano Lucà MD 1 |  \nImmacolata Cozzolino MD, PhD1  | Marina Accardo MD 1 |  \nCarminia Della Corte MD, PhD3 | Francesco Iovino MD, PhD4 | Simona Parisi MD4 | Ilaria Tedesco BD1 | Francesco Ingallinella MD1 | Francesca Grasso MD2 |  \nRenato Franco MD, PhD1  | Marco Montella MD, PhD1   \n1Department of Mental Health and Physic and Preventive Medicine, University of Campania Luigi Vanvitelli, Naples, Italy  \n2Caserta Local Health Authority, Caserta, Italy 3Department of Precision Medicine, Faculty of Medicine and Surgery, University of Campania“L. Vanvitelli”, Naples, Italy  \n4Department of Advanced Medical and Surgical Sciences, University of Campania“Luigi Vanvitelli”, Naples, Italy  \nCorrespondence  \nMarco Montella, Department of Mental and Physical Health and Preventive Medicine, Università degli Studi della Campania Luigi Vanvitelli, Via Luciano Armanni 5, Naples 80138, Italy. [Email:](Email: marco.montella@unicampania.it)[ marco.montella@unicampania.it](Email: marco.montella@unicampania.it)  \nABSTRACT  \nBackground: HER2-positive invasive breast carcinomas (IBCs) account for 15% of breast cancers and are driven by ERBB2 gene amplification. Although historically associated with aggressive behavior, HER2-targeted therapies have significantly improved outcomes. HER2 status is routinely assessed by immunohistochemistry (IHC) and in situ hybridization (ISH). Recently, tumors with low HER2 expression (IHC 1+ or 2+ without amplification), previously classified as HER2-negative, have emerged as a clinically relevant subgroup. Fine-needle aspiration cytology (FNAC) is a minimally invasive alternative to core needle biopsy, particularly useful in inoperable or metastatic settings. FNAC-derived cell blocks (CBs) allow immunocytochemical (ICC) evaluation of biomarkers.  \nMethods: This retrospective study included 46 FNAC-derived CBs from breast cancers (34 primary tumors and 12 metastases) collected at Vanvitelli University Hospital. ICC evaluation of HER2, estrogen receptor (ER), and progesterone receptor (PR) was independently performed by two expert pathologists and compared with corresponding histological assessments. Diagnostic performance was evaluated using sensitivity, specificity, predictive values, concordance rates, and receiver operating characteristic (ROC) curve analysis.  \nResults: ICC on FNAC-derived CBs showed good diagnostic performance for HER2-low tumors. Sensitivity ranged from 56. 3% to 59.4%, whereas specificity was high (85.7%–92. 9%). Positive predictive values reached 90.0%–95.0%, whereas negative predictive values were lower (46.2%–50.0%). Concordance between cytological and histological HER2-low assessment exceeded 90%, with ROC area under the curve values of 0.71–0.76. ER showed excellent concordance, whereas PR demonstrated moderate agreement.  \nThe first two authors contributed equally to this article.  \nThis is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.  \n© 2026 The Author(s). Cancer Cytopathology published by Wiley Periodicals LLC on behalf of American Cancer Society.  \nConclusions: FNAC-derived CBs are a reliable tool for identifying HER2-low breast carcinomas when histological samples are unavailable or limited, emphasizing the need for standardized evaluation criteria.  \nKEYWORDS  \ncell block, diagnostic accuracy, fine-needle aspiration cytology, HER2-low breast cancer, immunocytochemistry  \nINTRODUCTION  \nHER2-positive invasive breast carcinomas (IBCs) are clinically significant subtypes, accounting for approximately 15% of all breast cancer cases. HER2 overexpression is driven by ERBB2 gene amplification, commonly seen in two molecular subtypes of breast cancer characterized by aggressive","cbCaiiUlERBNssOV","https://ap.wps.com/l/cbCaiiUlERBNssOV","pdf",1953494,"English","# Abstract\n## Background\n## Methods\n## Results\n## Conclusions\n# Introduction\n## Background and clinical relevance of HER2 status\n## ASCO/CAP evaluation recommendations\n## Challenges in distinguishing HER2-low from HER2-negative","[{\"question\":\"What is the study aiming to evaluate?\",\"answer\":\"The study evaluates diagnostic accuracy for detecting HER2-low status in FNAC-derived cell blocks from primary and metastatic breast cancers, compared with histological assessments.\"},{\"question\":\"How were biomarkers measured in the cell blocks?\",\"answer\":\"Immunocytochemical evaluation of HER2, ER, and PR was independently performed by two expert pathologists on FNAC-derived cell blocks and compared with corresponding histology.\"},{\"question\":\"What diagnostic performance did the study report for HER2-low detection?\",\"answer\":\"ICC on FNAC-derived CBs showed good diagnostic performance, with sensitivity in the mid-to-high 50% range, high specificity (about 86%–93%), PPV around 90%–95%, and concordance above 90% with ROC AUC values of roughly 0.71–0.76.\"}]","High accuracy in detecting HER2-low status in FNA of primary and metastatic breast cancer | PDF",1790099930,25]