{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T06:53:38Z","timestamp":1791269618268,"version":"4.1.0"},"reference-count":20,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T00:00:00Z","timestamp":1791158400000},"content-version":"vor","delay-in-days":4,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100008700","name":"Centre International de Recherche sur le Cancer","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008700","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Accurate detection of estrogen and progesterone receptors (ER\/PR), HER2, and Ki\u201067 is essential for molecular classification of breast cancer and in deciding upon tailored treatment. In many low\u2010 and middle\u2010income countries (LMICs), access to histopathology and immunohistochemistry (IHC) is limited. STRAT4, an automated RT\u2010qPCR assay performed on the widely available GeneXpert platform, offers a potential alternative. We evaluated the performance of STRAT4 on core biopsy, unstained smear of fine\u2010needle aspiration biopsy (FNAB\u2010US), and cellblock samples compared with conventional IHC in 178 histopathology\u2010confirmed breast cancer patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Matched core biopsy, cellblock, and FNAB\u2010US samples were analyzed using STRAT4. Concordance with IHC for ER, PR, HER2, and Ki\u201067 was assessed using percentage agreement and kappa statistics. The effect of alternative d\n                      <jats:italic>C<\/jats:italic>\n                      <jats:sub>t<\/jats:sub>\n                      cut\u2010offs used in an earlier study was also examined. Molecular subtype classification derived from STRAT4 was compared with IHC\u2010based classification.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Concordance between STRAT4 and IHC was high for ER across all sample types (\n                      <jats:italic>\u03ba<\/jats:italic>\n                      : 0.78\u20130.86). PR detection showed substantial agreement for core biopsies (\n                      <jats:italic>\u03ba<\/jats:italic>\n                      \u2009=\u20090.78) and cellblocks (\n                      <jats:italic>\u03ba<\/jats:italic>\n                      \u2009=\u20090.63), but only fair for FNAB\u2010US samples (\n                      <jats:italic>\u03ba<\/jats:italic>\n                      \u2009=\u20090.53). HER2 detection showed moderate agreement (\n                      <jats:italic>\u03ba<\/jats:italic>\n                      \u2009=\u20090.41\u20130.58), improving with modified cut\u2010offs (\n                      <jats:italic>\u03ba<\/jats:italic>\n                      \u2009=\u20090.57\u20130.66), especially for FNAB\u2010US. Ki\u201067 concordance was low (agreement 58.9%\u201371.0%). Kappa values indicating agreement between molecular subtype classifications using STRAT4 on various samples and routine IHC were as follows: core biopsies\u2009=\u20090.60; cellblocks\u2009=\u20090.61; FNAB\u2010US samples\u2009=\u20090.45.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Detection of ER from FNAB\u2010US, cellblocks, and core biopsies using STRAT4 showed high concordance with IHC. However, the concordance was low to moderate for other markers.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cam4.72359","type":"journal-article","created":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T06:42:48Z","timestamp":1791268968000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Automated\n                    <scp>mRNA<\/scp>\n                    \u2010Based Detection of\n                    <scp>ER<\/scp>\n                    ,\n                    <scp>PR<\/scp>\n                    ,\n                    <scp>HER2<\/scp>\n                    , and Ki\u201067 in Breast Cancer Tissue and Cytology Samples in Resource\u2010Limited Settings"],"prefix":"10.1002","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0124-4050","authenticated-orcid":false,"given":"Partha","family":"Basu","sequence":"first","affiliation":[{"name":"Early Detection, Prevention &amp; Infections Branch International Agency for Research on Cancer  Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-9007-9630","authenticated-orcid":false,"given":"Anuradha","family":"Talukdar","sequence":"additional","affiliation":[{"name":"Cachar Cancer Hospital &amp; Research Centre  Silchar India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Poulome","family":"Mukherjee","sequence":"additional","affiliation":[{"name":"Cachar Cancer Hospital &amp; Research Centre  Silchar India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Muwonge","sequence":"additional","affiliation":[{"name":"Early Detection, Prevention &amp; Infections Branch International Agency for Research on Cancer  Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1252-1925","authenticated-orcid":false,"given":"Eric","family":"Lucas","sequence":"additional","affiliation":[{"name":"Early Detection, Prevention &amp; Infections Branch International Agency for Research on Cancer  Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monoj Kumar","family":"Deka","sequence":"additional","affiliation":[{"name":"Cachar Cancer Hospital &amp; Research Centre  Silchar India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanjit","family":"Bal","sequence":"additional","affiliation":[{"name":"Department of Histopathology Postgraduate Institute of Medical Education and Research  Chandigarh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Upasana","family":"Gautam","sequence":"additional","affiliation":[{"name":"Department of Cytology &amp; Gynaecological Pathology Postgraduate Institute of Medical Education and Research  Chandigarh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3551-2060","authenticated-orcid":false,"given":"Manish","family":"Rohilla","sequence":"additional","affiliation":[{"name":"Department of Cytology &amp; Gynaecological Pathology Postgraduate Institute of Medical Education and Research  Chandigarh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Baneet","family":"Bansal","sequence":"additional","affiliation":[{"name":"Department of Cytology &amp; Gynaecological Pathology Postgraduate Institute of Medical Education and Research  Chandigarh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7351-4964","authenticated-orcid":false,"given":"Veenu","family":"Singla","sequence":"additional","affiliation":[{"name":"Department of Radiodiagnosis and Imaging Postgraduate Institute of Medical Education and Research  Chandigarh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9142-1115","authenticated-orcid":false,"given":"Siddhant","family":"Khare","sequence":"additional","affiliation":[{"name":"Department of General Surgery Postgraduate Institute of Medical Education and Research  Chandigarh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7214-6402","authenticated-orcid":false,"given":"Andre Lopes","family":"Carvalho","sequence":"additional","affiliation":[{"name":"Early Detection, Prevention &amp; 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