{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T23:06:22Z","timestamp":1790723182766,"version":"4.1.0"},"reference-count":32,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T00:00:00Z","timestamp":1772150400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T00:00:00Z","timestamp":1772150400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Cytopathology"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>HER2\u2010positive invasive breast carcinomas (IBCs) account for 15% of breast cancers and are driven by ERBB2 gene amplification. Although historically associated with aggressive behavior, HER2\u2010targeted 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\u2010negative, have emerged as a clinically relevant subgroup. Fine\u2010needle aspiration cytology (FNAC) is a minimally invasive alternative to core needle biopsy, particularly useful in inoperable or metastatic settings. FNAC\u2010derived cell blocks (CBs) allow immunocytochemical (ICC) evaluation of biomarkers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective study included 46 FNAC\u2010derived 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>ICC on FNAC\u2010derived CBs showed good diagnostic performance for HER2\u2010low tumors. Sensitivity ranged from 56.3% to 59.4%, whereas specificity was high (85.7%\u201392.9%). Positive predictive values reached 90.0%\u201395.0%, whereas negative predictive values were lower (46.2%\u201350.0%). Concordance between cytological and histological HER2\u2010low assessment exceeded 90%, with ROC area under the curve values of 0.71\u20130.76. ER showed excellent concordance, whereas PR demonstrated moderate agreement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>FNAC\u2010derived CBs are a reliable tool for identifying HER2\u2010low breast carcinomas when histological samples are unavailable or limited, emphasizing the need for standardized evaluation criteria.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cncy.70085","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T12:07:34Z","timestamp":1772971654000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["High accuracy in detecting HER2\u2010low status in FNA of primary and metastatic breast cancer"],"prefix":"10.1002","volume":"134","author":[{"given":"Giuseppe","family":"D\u2019Abbronzo","sequence":"first","affiliation":[{"name":"Department of Mental Health and Physic and Preventive Medicine University of Campania Luigi Vanvitelli  Naples Italy"},{"name":"Caserta Local Health Authority  Caserta Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano","family":"Luc\u00e0","sequence":"additional","affiliation":[{"name":"Department of Mental Health and Physic and Preventive Medicine University of Campania Luigi Vanvitelli  Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6655-0078","authenticated-orcid":false,"given":"Immacolata","family":"Cozzolino","sequence":"additional","affiliation":[{"name":"Department of Mental Health and Physic and Preventive Medicine University of Campania Luigi Vanvitelli  Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marina","family":"Accardo","sequence":"additional","affiliation":[{"name":"Department of Mental Health and Physic and Preventive Medicine University of Campania Luigi Vanvitelli  Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carminia","family":"Della Corte","sequence":"additional","affiliation":[{"name":"Department of Precision Medicine Faculty of Medicine and Surgery University of Campania \u201cL. Vanvitelli\u201d  Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Iovino","sequence":"additional","affiliation":[{"name":"Department of Advanced Medical and Surgical Sciences University of Campania \u201cLuigi Vanvitelli\u201d  Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simona","family":"Parisi","sequence":"additional","affiliation":[{"name":"Department of Advanced Medical and Surgical Sciences University of Campania \u201cLuigi Vanvitelli\u201d  Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilaria","family":"Tedesco","sequence":"additional","affiliation":[{"name":"Department of Mental Health and Physic and Preventive Medicine University of Campania Luigi Vanvitelli  Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Ingallinella","sequence":"additional","affiliation":[{"name":"Department of Mental Health and Physic and 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