294P Evaluating malignancy risk in soft tissue FNAs: Insights from the WHO reporting framework

March 1, 2026ESMO rare cancers.Open Access

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Key Points

This research aims to assess the risk of malignancy in soft tissue fine needle aspirations and analyze the implications of molecular alterations in mTNBC.
Evaluated tumor mutational burden (TMB) in samples, defined as >10 mut/MB
Assessed PD-L1 expression using 22C3 and SP142 assays
Estimated cell infiltration in the tumor microenvironment via quanTIseq
Analyzed overall survival (OS) using insurance claims data from biopsy to last contact
Compared genetic alterations between ERBB3-High and ERBB3-Low mTNBC samples
ERBB3-High mTNBC showed mutations in TP53 (86%), RB1 (15%), and KMT2C (10%)
Higher prevalence of PD-L1 expression in ERBB3-High samples (22C3: 46% vs 35%; SP142: 59% vs 44%)
Proinflammatory immune cell fractions were elevated in ERBB3-High samples
Patients with ERBB3-High mTNBC had significantly improved OS (median 31 vs. 20 months; p=0.0032)
ERBB3 may serve as a prognostic biomarker for treatment strategies in mTNBC

This analysis evaluates malignancy risk in soft tissue FNAs, indicating implications for treatment strategies in mTNBC.

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Ayesha Khan (2026) studied this question.

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