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. 2014 Mar 4:14:147.
doi: 10.1186/1471-2407-14-147.

Invasive neuroendocrine carcinoma of the breast: a population-based study from the surveillance, epidemiology and end results (SEER) database

Jun Wang, Bing Wei, Constance T Albarracin, Jianhua Hu, Susan C Abraham, Yun Wu  1
Affiliations

Invasive neuroendocrine carcinoma of the breast: a population-based study from the surveillance, epidemiology and end results (SEER) database

Jun Wang et al. BMC Cancer. .

Abstract

Background: Neuroendocrine carcinoma (NEC) of the breast is a rare type of carcinoma that has not been well studied or characterized. Of the limited number of studies reported in the literature, most are case reports. A few small retrospective series studies have been reported.

Methods: We reviewed data on 142 cases of mammary NEC recorded in the surveillance, epidemiology, and end results (SEER) database during 2003-2009 and evaluated disease incidence and patient age, sex, and race/ethnicity; clinicopathologic characteristics; and survival in comparison to invasive mammary carcinoma, not otherwise specified. We also performed univariate and multivariate analyses to identify prognostic factors in this disease.

Results: Review of the 142 SEER cases revealed that NEC is an aggressive variant of invasive mammary carcinoma. It generally occurred in older women (>60 years); present with larger tumor size (>20 mm), higher histologic grade, and higher clinical stage; and result in shorter overall survival and disease-specific survival than invasive mammary carcinoma, not otherwise specified (IMC-NOS). Overall survival and disease-specific survival were shorter in NEC at each stage than in IMC-NOS of the same stage. Furthermore, when all NEC and IMC-NOS cases were pooled together, neuroendocrine differentiation itself was an adverse prognostic factor independent of other known prognostic factors, including age, tumor size, nodal status, histologic grade, estrogen/progesterone receptor status, and therapy.

Conclusions: NEC is a rare but aggressive type of mammary carcinoma. Novel therapeutic approaches should be explored for this uniquely clinical entity.

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Figures

Figure 1
Figure 1
Overall survival (OS) and disease-specific survival (DSS) comparisons between neuroendocrine carcinoma (NEC) and invasive mammary carcinoma, not otherwise specified (IMC) diagnosed between 2003 and 2009. OS and DSS were significantly shorter in NEC than in IMC-NOS in both early stage disease (A and C) and advanced stage disease (B and D).
Figure 2
Figure 2
Factors affecting overall survival (OS) of mammary NEC. Age (A), tumor size (B), lymph node status (C), stage (D), histologic grade (E), estrogen receptor (ER) and progesterone receptor (PR) status (F, G), surgical resection (H) and radiation therapy (I) were analyzed.
Figure 3
Figure 3
Factors affecting disease-specific survival (DSS) of mammary NEC. Age (A), tumor size (B), lymph node status (C), stage (D), histologic grade (E), estrogen receptor (ER) and progesterone receptor (PR) status (F, G), surgical resection (H) and radiation therapy (I) were analyzed.
Figure 4
Figure 4
Overall survival (OS) and disease-specific survival (DSS) comparisons between neuroendocrine carcinoma (NEC) and invasive mammary carcinoma, not otherwise specified (IMC) diagnosed between 1998 and 2002. Although OS was significantly shorter in NEC than in IMC-NOS in early stage disease (A), there was no difference in DSS between NEC and IMC-NOS (C). There was no difference in both OS and DSS between NEC and IMC-NOS in advanced stage disease (B and D).
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