Prognostic factors of primary neuroendocrine breast cancer: A population‐based study

Abstract

Background Primary neuroendocrine breast carcinomas (NEBCs) are an extremely rare and underrecognized subtype of mammalian carcinoma. The prognostic factors for NEBCs remain controversial. Methods In this multicenter retrospective study, the prognostic factors for patients with primary NEBCs who underwent surgery and had a pathologically confirmed diagnosis of neuroendocrine carcinoma in China and the United States were examined. The endpoints were disease‐free survival (DFS) and overall survival (OS). Results A total of 51 Chinese patients and 98 US patients were included. In the Chinese cohort, tumor grade and Ki‐67 levels were prognostic factors for DFS in univariate analysis (hazard ratio [HR] = 5.11 [1.67–15.60], p = 0.004; HR = 57.70 [6.36–523.40], p < 0.001, respectively) and multivariate analysis (HR = 100.52 [1.33–7570.21], p = 0.037; HR = 31.47 [1.05–945.82], p = 0.047, respectively). In the US cohort, age was an important prognostic factor for OS in univariate analysis (HR = 1.09 [1.04–1.15], p = 0.001). The random effects model for the combined cohorts revealed age and positive expression of estrogen receptor (ER) as potential prognostic factors for OS (HR = 1.08 [1.01–1.14], p = 0.015; HR = 0.10 [0.02–0.44], p = 0.003, respectively). Conclusions Tumor grade and Ki‐67 levels are important prognostic factors for DFS of patients with primary NEBCs. Age and ER status are important prognostic factors for OS of patients with primary NEBCs.

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

“…Br-NEN rarely affects males, in our cohort we had no male patient. Age and family history are currently considered the primary risk factors for Br-NEN, similar to non-neuroendocrine BC (8,9,18,19). In the largest study with over 140 Chinese and American patients with neuroendocrine breast carcinomas the tumor grade and Ki-67 levels played a crucial role as prognostic factors for disease-free survival (DFS), while the age and ER status were significant prognostic factors for overall survival (OS) (9).…”

“…Due to their diverse nature and rarity, prognostic factors as well as treatment guidelines remain controversial. Br-NENs are usually luminal (ER and/or PR) positive and HER-2 negative (7,9). Data regarding prognosis are ambiguous, and it appears that few factors can influence it, including the level of expression of neuroendocrine markers, grade, stage, Ki-67 level, and presence of ER/PR (8).…”

Differences in clinical characteristics and prognosis between breast neuroendocrine carcinoma and breast invasive ductal carcinoma: A multicentre population‐based study from China

“…Several studies have confirmed that NEC has a higher rate of local recurrence, a higher rate of lymph node metastasis, and worse survival than IDC 14,15 . Considering that clinical variables such as age at initial diagnosis, molecular subtype and tumour stage may be potential confounders in survival analysis, coupled with the fact that pathological grade and Ki‐67 are prognostic factors for NEC, 6 our team obtained a similar conclusion after eliminating differences in clinical characteristics between IDC and NEC cohorts by propensity score matching that NEC had worse DFS than IDC. Therefore, we believe that the type of breast neuroendocrine neoplasms should be clarified during survival analysis to give readers a clearer elucidation.…”

“…All information was collected from a routine medical records system using a self‐designed case report form (CRF). Additional details are provided in another study by our team 6 …”

Neuroendocrine breast carcinoma

“…Evidence shows that the NEBC grade and Ki67 percentage are prognostic factors affecting disease-free survival and that age and ER status are prognostic factors impacting overall survival. 5 …”