Invasive Neuroendocrine Carcinoma of the Breast: A Prognostic Research of 107 Chinese Patients

Abstract

Neuroendocrine carcinoma (NEC) of the breast, a distinct type of mammary carcinoma whose terminology was not proposed until 2003, has not been well recognized or studied. The aim of our study is to evaluate the clinicopathological features and outcomes of this type of tumor. We conducted a comparative study on 107 NEC patients and 475 invasive ductal carcinoma, not otherwise specified(IDC, NOS) patients from the Department of Pathology, Huashan Hospital, Fudan University, to determine the demographic, pathological, and clinical features at presentation, along with patient outcomes and prognostic factors. With an older age at presentation, NECs are more likely to be estrogen receptor(ER)/ progesterone receptor (PR) positive and human epidermal growth factor receptor 2 (HER-2) negative, and have a higher propensity for local recurrence and poorer overall survival(OS). Higher T classification, M classification, TNM stage, the expression of Ki67, and the absence of PR expression are prognostically of poorer OS and distant recurrence-free survival(DRFS). Distant metastasis is also a dependent prognostic factor. NEC of the breast is a distinct type of neoplasm with higher malignancy. Novel therapies such as the endocrine therapy should be explored and studies with larger case number and longer follow-up will be needed.

Clinicopathological Study of Neuroendocrine Carcinoma of the Breast

“…NECs of the breast are usually seen in mature women, around the seventh or eighth decade of life, and the tumors tend to be larger (measuring ≥20 mm in diameter), higher grade, and more advanced than usual breast cancers. Studies have found both progression free survival and overall survival to be shorter than those of patients with usual IDC [7] [8]. However, in the present study, the patients with NEC had survival rates similar to those of patients with usual IDC and had favorable outcomes (MST of 75 months).…”

Neuroendocrine Carcinoma of the Breast: Current Evidence and Future Perspectives

“…In fact, in a large series of Chinese patients with NECB, Ki67 . 14% was significantly associated with worse DFS and OS [36]. When the specific histologic subgroup was taken into account, small-cell carcinoma was significantly associated with worse prognosis in comparison with all the other neuroendocrine tumors of the breast [1].…”

“…As reported above, HER2 is only sporadically expressed by NECB [6,18,36]. The prognostic role of HER2 in NECB is not clear, but it is conceivable that it is analog to that observed for other invasive breast carcinomas; therefore anti-HER2 therapy should be considered for HER2-positive NECB.…”

Primary Neuroendocrine Carcinoma of Breast: an uncommon variant.

“…It is extremely rare tumor accounting for 0.27 to 0.50% of histopathologically proven breast cancers [1,2] . Most neuroendocrine carcinomas are located in gastrointestinal tract and lung [3] .…”