Naslov
Neuroendocrine cancer of the breast: a report of 11 cases

Autori
Perić Balja, Melita ; Ramić, Snježana ; Bujas, Tanja ; Knežević, Fabijan

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, stručni

Izvornik
Acta clinica Croatica 49(2) / - , 2010, 227-228

Skup
21st Ljudevit Jurak International Symposium on Comparative Pathology

Mjesto i datum
Zagreb, Hrvatska, 04.06.2010. - 05.06.2010

Vrsta sudjelovanja
Poster

Vrsta recenzije
Domaća recenzija

Ključne riječi
neuroendocrine differentiation ; breast cancer

Sažetak
Primary neuroendocrine cancer of the breast is rare. They exhibit morphological features similar to those of neuroendocrine tumors of other origins. Expression of neuroendocrine markers chromogranin and/or synaptophysin in more than 50% of the cell population, confirms neuroendocrine differentiation. Neuroendocrine breast cancer usually shows alveolar structures or solid sheets of cells with a tendency to produce peripheral palisading or insular structures separated by a delicate fibrovascular stroma, plasmacytoid, spindle and signet-ring cells and mucinous differentiation. Depending upon the cell types, grade and degree of differentiation, neuroendocrine carcinoma has been categorized in the following subtypes: solid, small cell and large cell neuroendocrine carcinoma. Histological grade, mucinous differentiation, and expression of estrogen and progesterone receptors are reliable features that are indicative of the clinical outcome. We report 11 patients with breast cancer with neuroendocrine differentiation underwent surgical treatment at University Hospital for Tumors, Zagreb, Croatia from January 2005 to December 2009 year. Materials and methods: All patients were aged from 48 to 86 (median 57) years. The tumor size median was 17 mm (range 10 to 48 mm) in diameter. Eight tumors were classified as solid, two as small cell and one as large cell type. Immunohistochemical examination was carried out using the following antibodies: chromogranin A, synaptophysin, estrogen receptor (ER), progesterone receptor (PR), androgen receptor (AR), human epidermal growth factor receptor-2 (HER-2) and Ki67. Results: Positive reactivity for chromogranin A (8/11, in 80-100% cells) and synaptophysin (11/11, in 50-100% cells) confirmed neuroendocrine differentiation in 11 cases of the breast cancer. Immunohistochemically, tumors expressed ER (11/11), PR (8/11) and AR (10/11) while HER-2 was negative in all cases. Median value for Ki-67 was 18% (range 7-55) and number of mitosis median was 4 (range 3-31). In one way analysis of variance histological grade was significantly influenced by the number of mitoses (P=0.0096) and tumor size (P=0.0035). Axillary lymph nodes were positive in two patients (2/11). Disease recurrence with distant metastases occurred, after 20 months, only in patient with large cell subtype. Median follow-up was 20.5 months (range 11-45 months). All other patients were free of disease at the time of writing. Conclusion: Neuroendocrine-differentiated carcinomas of the breast frequently express ER, PR and AR while HER-2 is negative. Expression of neuroendocrine markers together with morphology is the mainstay of diagnosis. Histological type, grade and size of tumor are very important prognostic factors in this tumour. More cases and longer follow-up periods are required to determinate the behavior of these tumors. These tumours often occur in elderly patients and often have low levels of aggressivity. The coexistence of both exocrine and neuroendocrine differentiation can lead to some uncertainty about the choice of the best antineoplastic strategy. Should these patients be treated as if they had ‘ordinary’ breast cancer or might they benefit from a specific treatement for pure neuroendocrine tumours?

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

Napomena
Kongres s međunarodnim sudjelovanjem

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