Neuroendocrine Carcinoma Of The Breast Research Articles

A rare case report of a primary large-cell neuroendocrine carcinoma of the breast with coexisting Paget disease

Neuroendocrine carcinomas are malignancies deriving from neuroendocrine cells existing in various sites of the body, most commonly in the lungs and gastrointestinal tract. Primary neuroendocrine carcinomas of the breast are extremely rare, and their diagnosis is confirmed by positive neuroendocrine markers. We describe a case of a 46-year-old woman with a palpable mass in her left breast for the previous 3 months. The tumor was resected and a primary large-cell neuroendocrine tumor of the breast was confirmed by histopathologic examination. Paget disease of the nipple was noted as well.

Neuroendocrine cells associated with neuroendocrine carcinoma of the breast: nature and significance

BackgroundThe developmental mechanisms of breast neuroendocrine carcinoma (B-NEC) have not been sufficiently analysed and are not well understood.AimsTo investigate NE cells in the background tissues surrounding B-NECs.MethodsThree cases (four breasts)...

Neuroendocrine carcinoma of the breast

Summary Primary breast neuroendocrine carcinoma (BNEC) is rare. High-grade BNEC, such as small cell carcinoma and large cell carcinoma, sometimes exhibits specific histological features, and is easily diagnosed. Low-grade solid BNEC, however, may demonstrate no specific neuroendocrine features on histological examination, which serve to distinguish it from conventional invasive carcinoma. Here, we present the case of a 46-year-old woman who was suspected of having BNEC. Suspicion was initially aroused by crush artifact during the time of frozen section. Subsequent immunohistochemistry established the diagnosis of solid BNEC according to the criteria of the WHO definition.

Small-Cell Cancer of the Breast: What Is the Optimal Treatment? A Report and Review of Outcomes

Introduction Primary small-cell cancer of the breast, also known as oat cell carcinoma or neuroendocrine carcinoma of the breast, is a rare disorder with only a few cases reported in the literature since its first description by Wade et al in 1983. Little is known on the optimal treatment and outcomes and a wide variety of treatments, including surgery, chemotherapy, and radiation have been used with different outcomes.

Neuroendocrine carcinoma of the breast with a mucinous carcinoma component: A case report with review of the literature

Neuroendocrine carcinoma (NEC) of the breast is a rare distinct clinicopathological entity, which, clinically, tends not to be aggressive. Mucinous carcinoma of the breast is also a rare distinct entity and is classified into types A (paucicellular) and B (hypercellular). It is well known that type B mucinous carcinoma frequently shows neuroendocrine differentiation. However, the coexistence of NEC and mucinous carcinoma within the same breast tumor is extremely rare. In the present study, we report a case of solid NEC of the breast with a mucinous carcinoma component and discuss the tumorigenesis of this extremely rare lesion. A 37-year-old Japanese female presented with a right breast tumor. Mastectomy and removal of the right axillary lymph nodes were performed. The resected breast tumor was composed of solid NEC (approximately 85% of the tumor) and type B mucinous carcinoma components. The right axillary lymph nodes had metastatic solid NEC. Three years later, local recurrence of mucinous carcinoma occurred in the operation scar of the right thoracic wall. In addition, seven years after the first surgery, metastatic solid NEC in the liver was observed. Recent molecular studies clearly revealed that no differences in gene expression are present between type B mucinous carcinoma and NEC. Therefore, the present case may represent solid NEC and type B mucinous carcinoma as part of a spectrum with the same genetic background. Moreover, the prognosis of solid NEC is thought to be good, and metastasis is extremely rare. However, metastasis of solid NEC of the breast may occur at a later stage. Therefore, long-term follow-up is required for patients with solid NEC of the breast.

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

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.

Small-cell neuroendocrine carcinoma of the breast

A small-cell carcinoma is one of the histologic subtypes of primary neuroendocrine carcinomas of the breast. A small-cell carcinoma is a rare entity of the breast and exhibits similar morphologic features as neuroendocrine tumors of the gastrointestinal tract and lung. We present the imaging and pathologic findings of a primary small-cell neuroendocrine carcinoma of the breast. This is the first report of a primary small-cell carcinoma arising from the breast in Korea.

Bilateral primary breast neuroendocrine carcinoma in a young woman: Report of a case

Bilateral breast carcinoma accounts for approximately 5% of all patients with breast cancer, while neuroendocrine breast carcinomas comprise less than 5% of invasive breast carcinomas. In addition, most patients with breast neuroendocrine carcinomas are older. Therefore, bilateral primary breast neuroendocrine carcinoma at a young age is extremely rare. We herein report bilateral neuroendocrine carcinoma of the breast in a 29-year-old woman who underwent bilateral lumpectomy with the initial symptom of bilateral nipple discharge. Grossly, the lesions in both breasts were masses with infinite margins. Histologically, this case was consistent with primary neuroendocrine carcinoma arising in bilateral breasts. Cells from both breast tumors were positive for chromogranin A, neuron-specific enolase, synaptophysin, cytokeratin 7, estrogen receptor, and progesterone receptor, and negative for Her2, cytokeratin 34β12, cytokeratin 5/6, smooth muscle actin, p63, S-100 protein, and p53. The Ki67 and NE proliferative indices were below 1%. To the best of our knowledge, this is the first reported case in China of bilateral primary neuroendocrine carcinoma presenting in a young woman.

Primary neuroendocrine carcinoma of the breast: A rare and distinct entity

Neuroendocrine tumor of the breast is a rare tumor that is under diagnosed and treated. This is a retrospective study over three years of neuroendocrine breast carcinoma cases seen at the National Institute of Oncology in Morocco between May 2007 and 2010. We analyzed various characteristics: Patient demographics, histological diagnosis, disease stage, treatment effects and outcome, in 7 non-metastatic neuroendocrine breast carcinoma. One patient had relapsed five weeks after radical mastectomy and neoadjuvant chemotherapy. The site of relapse was local and pleural at the liver. All the remaining patients are in a good control. Of note, at median follow up of 28 months, the disease free survival for the entire group was 85%, all the patients are still alive. In conclusion, neuroendocrine carcinoma is a subtype of mammary carcinoma with several distinctive features. They appear more likely to be estrogen/progesterone receptor (positive) and human epidermal growth factor receptor 2 (negative). To date, the optimal treatment for neuroendocrine carcinoma of breast is not clear. Radical mastectomy with neoadjuvant or adjuvant chemotherapy, adjuvant radiotherapy and hormonal therapy appears as a viable option. Key words: Neuroendocrine carcinoma, breast carcinoma, chemotherapy, surgery, radiotherapy.

Primary neuroendocrine carcinoma of the breast: Report of a case

Primary neuroendocrine carcinoma (NEC) of the breast appears to be a rare neoplasm. Due to the limited number of the cases, a definitive therapeutic option for the disease has not yet been established. We herein report the case of a 57-year-old female patient with primary NEC of the breast who underwent a surgical resection and for whom the suitable adjuvant therapy is now being considered.

Prognostic significance of tumor grading and staging in mammary carcinomas with neuroendocrine differentiation

Invasive mammary carcinoma with neuroendocrine differentiation has been controversial in terms of its definition and clinical outcome. In 2003, the World Health Organization histologic classification of tumors designated this entity as neuroendocrine carcinoma of the breast and defined mammary neuroendocrine carcinoma as expression of neuroendocrine markers in more than 50% of tumor cells. It is an uncommon neoplasm. Our recent study showed that it is a unique clinicopathologic entity and has a poor clinical outcome compared with invasive mammary carcinoma with similar pathologic stage. Other investigators have also demonstrated a different molecular profile in this type of tumor from that of invasive ductal carcinoma. It is unknown whether the current prognostic markers for invasive mammary carcinoma are also applicable for neuroendocrine carcinoma of the breast. In the current study, we reviewed the clinicopathologic features and outcome data in 74 cases of mammary neuroendocrine carcinoma from the surgical pathology files at The University of Texas, MD Anderson Cancer Center, to identify relevant prognostic markers for this tumor type. As shown previously by univariate analysis, large tumor size, high nuclear grade, and presence of regional lymph node metastasis are adverse prognostic factors for overall survival and distant recurrence-free survival. In the current study, multivariate analysis revealed that overall survival was predicted by tumor size, lymph node status, and proliferation rate as judged by Ki-67 immunohistochemistry. Only nodal status proved to be a significant independent prognostic factor for distant recurrence-free survival. Neither mitosis score nor histologic grade predicted survival in mammary neuroendocrine carcinoma. Our data suggest that routine evaluation of Ki-67 proliferation index in these unusual tumors may provide more valuable information than mitotic count alone.

Fine needle aspiration cytology of solid neuroendocrine carcinoma of the breast: A case report

We report a case of neuroendcrine (NE) carcinoma in the right breast of a 67-year-old female, ultrasonography revealed a lesion composed of irregular hypoechoic masses and mammography showed asymmetric breast tissue. Histopathologic examination of the surgical sample showed a solid to nested proliferation of plasmacytoid cells that showed immunocytochemical positivity for chromogranin A, synaptophysin, CD56, and estrogen receptor. Our case was diagnosed as solid NE carcinoma. Though the findings of fine needle aspiration cytology reflected the histological features, we were not able to cytopathologic grounds only to predict the NE nature of this tumor. We performed immunocytochemistry using Chromogranin A, Synaptophysin, and CD56 on our cytologic smear retrospectively with positive results for all of the markers. When the cytopathologic examination of a given breast neoplasm is suggestive of NE differentiation, immunocytochemical staining for NE markers is generally useful for a correct preoperative diagnosis. An acurate preoperative diagnosis of NE carcinoma on FNAC can be achieved based on its distinctive cytomorphologic and immunocytochemical features.

An Unusual Case of Primary Small Cell Neuroendocrine Carcinoma of the Breast

Primary small cell neuroendocrine carcinoma of breast is a rare entity, with only case reports in literature. Histologically, these tumors are similar to small cell carcinoma of the lung with some evidence of ductal carcinoma-in-situ with areas of ductal, lobular, or papillary differentiation. Immunoreactivity for neuroendocrine markers is present in two thirds of cases, while 33-50% are positive for estrogen receptor or progesterone receptor. Her2/neu expression has not been reported in small cell carcinoma of the breast. Here we are presenting 53-year-old women with locally advanced primary small cell neuroendocrine carcinoma of breast. We will discuss clinicopathological findings, treatment options, prognosis and review of the literature on primary small cell carcinoma of breast.

Invasive neuroendocrine carcinoma of the breast: a distinctive subtype of aggressive mammary carcinoma.

Neuroendocrine carcinoma (NEC) of the breast, a pathologic entity newly defined in the 2003 World Health Organization classification of tumors, is a rare type of tumor that is not well recognized or studied. The purpose of this first case-controlled study is to reveal the clinicopathologic features, therapeutic response, and outcomes of patients with NEC of the breast. Seventy-four patients with NEC of the breast who were treated at The University of Texas M. D. Anderson Cancer Center were analyzed; 68 of them had complete clinical follow-up. Two cohorts of invasive mammary carcinoma cases were selected to pair with NEC to reveal demographic, pathologic, and clinical features at presentation, along with therapeutic response to treatment and patient outcomes. NEC was more likely to be estrogen receptor/progesterone receptor positive and human epidermal growth factor receptor 2 negative. Despite similar age and disease stages at presentation, NEC showed a more aggressive course than invasive ductal carcinoma, with a higher propensity for local and distant recurrence and poorer overall survival. High nuclear grade, large tumor size, and regional lymph node metastasis were significant negative prognostic factors for distant recurrence-free survival; high nuclear grade and regional lymph node metastasis were also significant negative prognostic factors for overall survival. Although endocrine therapy and radiation therapy showed a trend toward improved survival, the small number of cases in this study limited the statistical power to reveal therapeutic benefits in NEC of the breast. NEC is a distinct type of aggressive mammary carcinoma. Novel therapeutic approaches should be explored for this uniquely different clinical entity.

Primary Breast Carcinoid With Metastasis and Ectopic ACTH Secretion

Abstract: Carcinoid tumors most frequently develop in the gastrointestinal tract but have been described in many organs of the body. Primary neuroendocrine carcinoma of the breast is rare-only 31 cases have been reported in literature. Immunohistochemical examination showing expression of chromogranin and/or synaptophysin confirms evidence of neuroendocrine differentiation. In primary neuroendocrine carcinoma of the breast, more than 50% of the cell population shows neuroendocrine differentiation. Foci of neuroendocrine differentiation usually can be seen in breast carcinoma and are reported to be present in about 2% to 5% of breast cancer cases. Carcinoid tumor metastatic to the liver from the breast is very unusual. We report a case in which the patient underwent breast lumpectomy with axillary dissection. The tumor initially was diagnosed as an infiltrative lobular carcinoma with axillary lymph node metastasis. Re-examination of the breast tumor histopathology, however, proved it to be a primary carcinoid tumor.

Primary Neuroendocrine Carcinoma in the Breast: A Case Report

Neuroendocrine (NE) carcinoma is derived from the NE cells that are scattered throughout all the organ systems, and these NE cells are particularly prevalent in the bronchopulmonary and gastrointestinal tract.(1) Primary NE carcinoma of the breast is extremely rare and it accounts for less than 0.1% of all breast carcinomas, less than 1% of all NE neoplasms in the body and only 0.1% of all breast cancers.(1) However, NE differentiation has also been described in a subset of patients with typical breast carcinoma and the clinical and histopathological features of these patients overlap with those of primary NE carcinoma.(2) Therefore, discriminating pure NE carcinoma of the breast from an ordinary breast carcinoma that shows NE differentiation in focal areas remains difficult.(3) Radiologicaly, it’ s hard to differentiate pure NE carcinoma from other breast cancers. The prognosis of pure NE carcinoma is better than that for most breast cancers except small cell neuroendocrine tumors. In this report, we present a new cas e of primary NE carcinoma in the breast, and we review the relevant literature with paying particular attention to the general morphological features and the treatment approaches.

A case of cytokeratin 20-positive large-cell neuroendocrine carcinoma of the breast

We report a rare case of large-cell neuroendocrine carcinoma of the breast. A 63-year-old woman was admitted to our hospital with a firm mass in the right breast. Mammography revealed a high-density mass with specula, and ultrasonography showed a heterogeneous hypoechoic mass with irregular margin and posterior acoustical shadowing. She underwent breast-conserving surgery with axillary lymph node dissection. Histopathologically, the tumor consisted of large cells with polygonal and prominent nuclei and a small amount of eosinophilic cytoplasm, and these cells showed palisading arrangement with fibrous stroma. The tumor cells were positive for neuroendocrine markers such as NSE, synaptophysin, CD56 (NCAM), but not for chromogranin A. Interestingly, the tumor cells showed reactivity for cytokeratin 20 but not for cytokeratin 7. The immunostaining pattern is different from the usual adenocarcinoma of the breast. The patient received postoperative radiotherapy and was given adjuvant chemotherapy. She has remained disease-free for 44months.

Neuroendocrine small cell carcinoma of the breast: report of a case

A rare case of neuroendocrine small cell carcinoma (SmCC) of the breast is reported. A 51-year-old postmenopausal woman noticed a nodule approximately 3 cm in diameter in her right upper breast. Histologically, the tumor consisted of small ovoid to pleomorphic cells with hyperchromatic nuclei, and a large central area was occupied by acellular amorphous tissue. Extensive lymphatic permeation was seen around the tumor. Invasive and in situ ductal carcinoma foci were not observed in and surrounding the tumor. Immunohistochemically, estrogen and progesterone receptors and HER2/neu were all negative in the tumor cells. Synaptophysin and chromogranin A were diffusely positive in the tumor cells. Cytokeratin 8 was only positive in a few tumor cells. The labeling indices of Ki-67 and p53 were high in the tumor. Postoperatively, systemic studies including positron emission tomography were performed but failed to reveal any other possible primary sites, including lung. Based on these findings, the tumor was diagnosed as neuroendocrine primary SmCC of the breast. Postoperatively, the patient received a course of weekly paclitaxel. However, pelvic bone metastasis was identified on a bone scintigram 1 year after surgery. Mammary SmCC showing high Ki-67 and p53 index should be treated carefully because of their aggressive clinical behavior.

TUMEURS NEUROENDOCRINES PRIMITIVES DU SEIN

Introduction : Several morphological classifications have been proposed. The study of its clinical and pathological characteristics allows the establishment of prognosis and the choice of the adequate treatment. Materials and methods : We report four cases of neuroendocrine carcinoma of the breast. These tumors were mostly solid .Immunohistochemical analysis was important. The patients have undergone treatment by either simple mastectomy, or wide local excision. Results : All cases were neuroendocrines markers. Estrogens and progesterone’s positive. No significant association was found between neuroendocrine differentiation and tumour size grade, stage. Local recurrence occurred in one patient and without any distant metastases found. Discussion : These tumours express neuroendocrine markers in more than 50% of the tumor cells. Oestrogen and progesterone receptors are rarely positive. However, we determined immunohistochemically prominent receptor reactivity in our cases. Treatment is limited to surgery. The prognosis could be better in tumors detected with hormone sensitivity. Conclusion : A rare and distinct category. Identification of neuroendocrine breast cancer seems to have a prognostic implications.

Primary neuroendocrine carcinoma of the breast

Primary neuroendocrine carcinoma of the breast is rare-only about 30 cases have been reported in literature. Immunohistochemical examination showing expression of chromogranin and/or synaptophysin confirms evidence of neuroendocrine differentiation. Usually foci of neuroendocrine differentiation can be seen in breast carcinoma and are reported to be present in about 2-5% of breast cancer cases. Here, we report a case of breast carcinoma in which most of the areas studied on the tissue section showed neuroendocrine differentiation.