Neuroendocrine Tumors of the Breast: Single-Center Experience

Hasbay, Bermal; Aytaç, Hüseyin Özgür; Bolat, Fılız

doi:10.4274/ejbh.galenos.2021.6349

Cited by 4 publications

(4 citation statements)

References 16 publications

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“…Published data also included cases of Br-NENs negative for synaptophysin or/and chromogranin A staining, similar to one of our patients (21,22,24,31). Interestingly, when compared with other authors (e.g (27).) the percentage of luminal A subtypes is much lower in our cohort, although the prognosis in our patients was favorable.…”

Section: Resultscontrasting

confidence: 74%

“…However, due to the small number of tested patients, we cannot provide the percentage of those with a BRCA mutation. In other studies, the percentage of patients with a family history of BC (if assessed) was also high, around 20% (27). The majority of our patients detected the tumor themselves (see Table 3).…”

Section: Resultssupporting

confidence: 56%

“…Although metastases from NE tumors to the breast are rare, we have identified two cases with such suspicion in our registry. Other authors have also reported similar situations when collecting Br-NENs patients' cohorts (27).…”

Section: Resultsmentioning

confidence: 62%

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Non-metastatic primary neuroendocrine neoplasms of the breast: a reference cancer center’s experience of a heterogenous entity

Püsküllüoğlu,

Grela-Wojewoda,

Ambicka

et al. 2024

Front. Endocrinol.

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BackgroundPrimary neuroendocrine neoplasms of the breast (Br-NENs) are rare. The classification has been updated in recent years making interpretation of the data published challenging. It is unclear whether neuroendocrine differentiation is associated with poorer prognosis and what treatment approaches should be applied.MethodsThe database for breast cancer patients treated between 2009 and 2022 at the Maria Sklodowska-Curie National Research Institute of Oncology Branch Krakow was explored to search for Br-NENs. Patients’ medical and pathological data were collected and analyzed.ResultsWe included 22 females with Br-NEN without metastases at the time of diagnosis. The median age was 64 years (range: 28-88), Of the cases, 18 were hormone receptor positive, all were HER-2 negative, the median Ki67 was 27% (10-100%). The median tumor size at the time of diagnosis was 29.5mm (7-75mm), 9 patients were N-positive. DCIS was present in 5 cases. Only one case was negative for chromogranin and synaptophysin staining, but data were missing for 4 cases. Nine patients received adjuvant chemotherapy, mainly based on anthracyclines and taxanes, while 16 received adjuvant hormonal therapy and 15 received postoperative radiotherapy. Radical surgery was performed in all patients, but two underwent suboptimal tumorectomy. One patient had local recurrence, three experienced metastatic disease, all involving the lungs, but these patients are still alive. The median follow-up was 96 months (8–153). Two patients died, with a follow up time of no recurrence >4 years. Our results were compared to twelve case series collecting clinical data on Br-NENs, with median patient number of 10.5 (range: 3-142).ConclusionBr-NENs represent a heterogenous group of diseases, lacking data from prospective studies or clinical trials. There are no established treatment standards tailored for Br-NENs. Our patients’ cohort exhibited a favorable prognosis, potentially attributed to lower tumor stage and Ki67 index compared to other reported case series. We suggest that radical surgery and postoperative radiotherapy be administered akin to standard treatment for breast cancer of no special type. ESMO also advocates for this approach in systemic treatment, although we recommend considering platinum-based chemotherapy for patients with poorly differentiated Br-NENs exhibiting high Ki67.

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Section: Resultscontrasting

confidence: 74%

Section: Resultssupporting

confidence: 56%

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Non-metastatic primary neuroendocrine neoplasms of the breast: a reference cancer center’s experience of a heterogenous entity

Püsküllüoğlu,

Grela-Wojewoda,

Ambicka

et al. 2024

Front. Endocrinol.

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“…Intending to increase diagnostic reproducibility, WHO's latest edition of breast tumors classification [3] employs a uniform scheme for all human NE tumors across the different organ systems, as proposed by the International Agency for Research on Cancer [1]. However, when applied to the diagnostic practice, this classification has proven to be difficult to manage, and the existence of a pure Br-NEN is still controversial and widely debated in the literature, except for the extremely rare primary small cell carcinoma [12][13][14]. Indeed, in our experience, we can apply the category of pure Br-NENs in a small subset of cases, whereas mixed forms, in which NEN component co-exists with a NST or special type BC, are more common.…”

Section: Discussionmentioning

confidence: 99%

Neuroendocrine neoplasms of the breast: diagnostic agreement and impact on outcome

et al. 2022

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The classification of breast neuroendocrine neoplasms (Br-NENs) was modified many times over the years and is still a matter of discussion. In the present study, we aimed to evaluate the diagnostic reproducibility and impact on patient outcomes of the most recent WHO 2019 edition of breast tumor classification, namely, for neuroendocrine tumors (NETs) and neuroendocrine carcinomas (NECs). This multicentric observational study included 287 breast neoplasms with NE differentiation. The cases were blindly classified by three independent groups of dedicated breast and/or endocrine pathologists following the 2019 guidelines. Diagnostic concordance and clinical impact were assessed. We observed only a moderate overall diagnostic agreement across the three centers (Cohen’s kappa 0.4532) in distinguishing NET from solid papillary carcinomas (SPCs) and no special type carcinomas (NST) with NE differentiation. Br-NENs were diagnosed in 122/287 (42.5%) cases, subclassified as 11 NET G1 (3.8%), 84 NET G2 (29.3%), and 27 NEC (9.4%), the latter group consisting of 26 large-cell and 1 small-cell NECs. The remaining 165/287 (57.5%) cases were labeled as non-NEN, including SPC, mucinous, NST, and mixed NE carcinomas. While NET and non-NEN cases had a comparable outcome, the diagnosis of NECs showed negative impact on disease-free interval compared to NETs and non-NENs (p = 0.0109). In conclusion, the current diagnostic classification of Br-NENs needs further adjustments regarding morphological and immunohistochemical criteria to increase the diagnostic reproducibility among pathologists. Our data suggest that, apart from high-grade small- and large-cell NECs, Br-NENs behave like non-NEN breast carcinomas and should be managed similarly.

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Le neoplasie neuroendocrine della mammella: inquadramento diagnostico e gestione clinica

Baldelli,

De Fata,

Buzzetti

et al. 2024

L'Endocrinologo

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Neuroendocrine Tumors of the Breast: Single-Center Experience

Cited by 4 publications

References 16 publications

Non-metastatic primary neuroendocrine neoplasms of the breast: a reference cancer center’s experience of a heterogenous entity

Non-metastatic primary neuroendocrine neoplasms of the breast: a reference cancer center’s experience of a heterogenous entity

Neuroendocrine neoplasms of the breast: diagnostic agreement and impact on outcome

Le neoplasie neuroendocrine della mammella: inquadramento diagnostico e gestione clinica

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