Neuroendocrine differentiation in breast carcinoma: clinicopathological features and outcome. Issue 3 (17th August 2015)

• Record Type: Journal Article
• Authors: Bogina, Giuseppe; Munari, Enrico; Brunelli, Matteo; Bortesi, Laura; Marconi, Marcella; Sommaggio, Marco; Lunardi, Gianluigi; Gori, Stefania; Massocco, Alberto; Pegoraro, Maria C; Zamboni, Giuseppe
• Is Part Of: Histopathology. Volume 68:Issue 3(2016)
• Page Start: 422
• Page End: 432
• Publication Date: 2015-08-17
• Subjects: breast -- cancer -- neuroendocrine -- outcome; Histology, Pathological -- Periodicals; 611.018
• DOI: 10.1111/his.12766
• Languages: English
• ISSNs: 0309-0167

Abstract

Abstract : Aims: Primary neuroendocrine (NE) breast carcinoma (BC) is an entity with a wide range of prevalence and poorly defined clinical behaviour. We evaluated the prevalence, clinicopathological features and clinical outcome of NEBC. Methods and results: Immunohistochemical staining for synaptophysin and chromogranin A was performed on whole sections from 1232 consecutive cases of invasive BC. We divided NEBC into focal (10–49% positive cells) and diffuse (≥50% positive cells) and compared the outcome of patients with NEBC with strictly matched non‐NEBC. A total of 128 BC showed NE differentiation (10.4%): 84 diffuse (6.8%) and 44 focal (3.6%). NE differentiation showed a significant association with T4 stage ( P = 0.001), solid‐papillary and mucinous histotype ( P < 0.0001), G2 grading ( P = 0.002), positive oestrogen receptor (ER) ( P = 0.003) and progesterone receptor (PR) ( P = 0.002). Almost 90% of NEBC were ER + /HER2 − and more than half ER + /HER2 − /Ki67≥14%. Kaplan–Meier analysis revealed that patients with NEBC showed worse disease‐free survival (DFS) ( P = 0.04) compared to matched non‐NEBC. We did not find significant differences regarding clinicopathological features, DFS and CSS between diffuse and focal neuroendocrine BC. Conclusions: This study demonstrates that NEBC represents 7–10% of invasive BC and that NE differentiation does not affect the prognosis of BC in terms of CSS.