Neuroendocrine Breast Cancer. Clinical Observation. Personalized Approach

Sh Kh Gantsev,R A Rustamkhanov,A N Plikhta,G Schaller,K Sh Gantsev,Sh R Kzyrgalin

doi:10.24060/2076-3093-2021-11-2-144-148

Abstract

Introduction. Neuroendocrine breast tumors represent a rare subtype of breast cancer, accounting for less than 1 % of all neuroendocrine neoplasms. Starting from their pathology definition, and going through their prevalence, prognosis and treatment, our knowledge is still really uncertain.Materials and methods. The article presents a rare clinical observation of a neuroendocrine breast tumor. A breast fibroadenoma was diagnosed at the initial diagnosis stage in a private clinic; after a surgical treatment and further morphological study, it was estimated: a diagnosis of Cancer in situ of the left breast T1N0M0, stage I. Next, 3D-conformal remote radiation therapy was performed on the area of the left breast.Results and discussion. After conducting positron emission tomography, multiple metastases were detected in the lymph nodes, bones, and liver. Additionally, micropreparations were consulted at the Federal Reference Center in St. Petersburg and at an independent third-party molecular biological laboratory in Germany (Munich). Given all the instrumental, molecular biological, histological and immunohistochemical studies of the patient, an individual regimen of drug therapy was selected.Conclusion. After 18 months of personalized drug therapy, we observed a positive trend and a significant decrease in metabolic activity according to positron emission tomography.

Highlights

Neuroendocrine breast tumors represent a rare subtype of breast cancer, accounting for less than 1 % of all neuroendocrine neoplasms
In the 2003 World Health Organization (WHO) Pathology and Genetics of Tumours of the Breast and Female Genital Organs, BNEN were recognized as a distinct entity requiring — as diagnostic criteria — the expression of NE markers in more than 50 % of cells [5,6,7]
Albeit BNEN were firstly described more than 40 years ago, and have been categorized more and more precisely thereafter, its rarity, together with still persisting diagnostic uncertainties, hampers drawing a precise clinical and prognostic picture

Summary

Introduction

Neuroendocrine breast tumors represent a rare subtype of breast cancer, accounting for less than 1 % of all neuroendocrine neoplasms. In the 2003 World Health Organization (WHO) Pathology and Genetics of Tumours of the Breast and Female Genital Organs, BNEN were recognized as a distinct entity requiring — as diagnostic criteria — the expression of NE markers ( chromogranin and synaptophysin) in more than 50 % of cells [5,6,7]. It was later revised and the term changed into carcinomas with NE features in the 2012 WHO Classification of Tumours of the Breast [8]. The problem of diagnosing and treating NET in Russia is in the lack of statistical data on the morbidity and mortality caused by this pathology, the lack of doctors’ knowledge (oncologists, surgeons, endocrinologists, gastroenterologists) about the features of diagnosis, clinical course, principles of antitumor treatment and the lack of possibility or inaccessibility of IHC confirmation [10]

Methods

Results

Conclusion