Neuroendocrine differentiation in breast cancer: established facts and unresolved problems

Righi, Luisella; Sapino, Anna; Marchiò, Caterina; Papotti, Mauro; Bussolati, G.

doi:10.1053/j.semdp.2009.12.003

Cited by 112 publications

(104 citation statements)

References 48 publications

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“…Thus, neuroendocrine tumors of the breast were defined as tumors of epithelial origin, with morphology similar to gastrointestinal and pulmonary neuroendocrine tumors, expressing a neuroendocrine marker in at least 50% of the total cell population [2]. Chromogranin and synaptophysin show the best sensitivity and specificity as immunohistochemical neuroendocrine markers [10]. Also neuron-specific enolase can be occasionally positive in NECB [11], whereas CD56 and other immunohistochemical markers seem to be less sensitive and specific [12].…”

Section: Pathological Classificationmentioning

confidence: 99%

Neuroendocrine Carcinoma of the Breast: Current Evidence and Future Perspectives

et al. 2015

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Neuroendocrine carcinoma of the breast is considered a rare entity, and for this reason there are no data from prospective clinical trials on its optimal management. Early stage tumors are usually treated with the same strategy used for the other types of invasive breast cancer. Anthracycline-and taxane-based regimens represent the most frequently administered chemotherapy in neoadjuvant and adjuvant setting, as well as for metastatic disease, although combinations of platinum compounds and etoposide have been widely used, in particular for small-cell histology and tumors with a high proliferation index. For metastatic disease, a multimodality therapeutic strategy can be considered on an individual basis, with chemotherapy, endocrine therapy, peptide receptor radionuclide therapy, radiation therapy, surgery, or a combination of the above. In the near future, a better knowledge of the biology of these tumors will hopefully provide new therapeutic targets for personalized treatment. In this review, we discuss the current evidence and the future perspectives on diagnosis and treatment of neuroendocrine carcinoma of the breast. The Oncologist 2016;21:28-32 Implications for Practice: Neuroendocrine carcinoma of the breast (NECB) is a distinct entity of breast cancer. Clinical features and morphology are not helpful to distinguish NECB from other subtypes of breast cancer; therefore, immunohistochemistry markers for neuroendocrine differentiation, mainly chromogranin and synaptophysin, should be routinely used to confirm the diagnosis, especially in cases of mucinous or solid papillary carcinoma in which the suspicion of NECB may be relevant. Adjuvant treatment should be offered according to the same recommendations given for the other types of invasive breast cancer. An accurate diagnosis of NECB is also important in the metastatic setting, in which a multimodality approach including specific therapies such as peptide receptor radionuclide therapy can be considered.

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Section: Pathological Classificationmentioning

confidence: 99%

Neuroendocrine Carcinoma of the Breast: Current Evidence and Future Perspectives

et al. 2015

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“…Neuroendocrine differentiation has been described in human adenocarcinomas of the prostate, breast, stomach, lung, and colorectum, among others [1][2][3][4][5][6][7][8]. The clinical significance of this finding is debated and in any case differs among the various organs.…”

Section: Introductionmentioning

confidence: 99%

Increased neuroendocrine cells in resected metastases compared to primary colorectal adenocarcinomas

et al. 2010

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Neuroendocrine differentiation has been described in rectal adenocarcinomas receiving neoadjuvant therapy prior to radical surgery, but its clinical relevance is controversial and no data are currently available in colorectal carcinoma metastases as compared to primary tumors. The presence of chromogranin A positive tumor cells was investigated by means of immunohistochemistry on surgical specimens from 54 primary colorectal carcinomas and their corresponding metastases, resected at diagnosis or during tumor progression. In 47 patients, tumor metastases were resected 1 month to 12 years after chemotherapy and/or radiotherapy, while in the remaining seven patients no additional therapy after primary surgery was performed. In primary tumors, neuroendocrine differentiation was found in 12/54 cases (22.2%) as compared to 25/54 metastatic lesions (46.3%; p=0.01). The presence of neuroendocrine phenotype was not correlated with any clinical pathological parameter nor with a different proliferation index. However, patients having neuroendocrine cells in the primary tumor had a significantly shorter survival from the time of metastatic spread than those having not (33.3 vs. 55.5 months; p=0.04). In summary, our data show that colorectal carcinoma metastases contain a higher percentage of neuroendocrine differentiated cells as compared to their corresponding primaries, a finding possibly related to the influence of chemotherapy in neuroendocrine differentiation during colorectal carcinoma progression.

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“…These latter are generally pure forms of primary breast EPNECs and therefore the NE cell population largely exceeds the required 50% and reaches 90% to 100%. The other NE breast carcinomas are rather classical ductal or lobular carcinomas combined with a prominent (N50%) NE cell component having mucinous, trabecular, alveolar, or solid patterns, which morphologically have little to do with the currently discussed small or large cell NE cancers [40].…”

Section: Issue 1 221 Problem: How To Label These Tumors?mentioning

confidence: 98%

Extrapulmonary neuroendocrine small and large cell carcinomas: a review of controversial diagnostic and therapeutic issues

et al. 2014

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Summary Extrapulmonary neuroendocrine carcinoma (EPNEC) is a heterogeneous and rare group of high-grade neoplasms occurring in different organs. They usually share a poor prognosis, but diagnostic and therapeutic options still include several controversial issues, due to the rarity of this condition and to differences in architecture and cell size, being some cases pure small cell carcinomas, other pure large cell neuroendocrine carcinomas and some others combined/mixed neuroendocrine carcinomas with a conventional non-neuroendocrine carcinoma. In addition, the therapeutic strategy varies in different organs (surgery and/or chemotherapy and/or radiation therapy and/or targeted treatments), and clinicians and pathologists are asked to interact to reach an accurate classification of every single case, as well as the most appropriate selection of the treatment options, even considering different time points of each EPNEC natural history. This overview highlights controversial pathological and clinical issues and summarizes possible solutions to most of such EPNEC-related problems.

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Neuroendocrine differentiation in breast cancer: established facts and unresolved problems

Cited by 112 publications

References 48 publications

Neuroendocrine Carcinoma of the Breast: Current Evidence and Future Perspectives

Neuroendocrine Carcinoma of the Breast: Current Evidence and Future Perspectives

Increased neuroendocrine cells in resected metastases compared to primary colorectal adenocarcinomas

Extrapulmonary neuroendocrine small and large cell carcinomas: a review of controversial diagnostic and therapeutic issues

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