Ozaki Yukinori, Miura Sakiko, Oki Ryosuke, Morikawa Teppei, Uchino Keita
Department of Medical Oncology, NTT Medical Center Tokyo, Tokyo 141-8625, Japan.
Department of Breast Medical Oncology, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo 135-8550, Japan.
Cancers (Basel). 2021 Dec 31;14(1):196. doi: 10.3390/cancers14010196.
Breast tumors with neuroendocrine (NE) differentiation comprise an uncommon and heterogeneous group of tumors, including invasive breast cancer of no special type (IBC-NST) with NE features, neuroendocrine tumors (NETs), and neuroendocrine carcinoma (NEC). The most recent World Health Organization (WHO) classification in 2019 defined neuroendocrine neoplasms (NENs) of the breast (Br-NENs) as tumors in which >90% of cells show histological evidence of NE differentiation, including NETs (low-grade tumors) and NEC (high-grade). Due to the low prevalence of these tumors and successive changes in their diagnostic criteria over the years, only limited evidence of these tumors exists, derived mainly from case reports and retrospective case series. Breast tumors with NE differentiation are usually treated like the more commonly occurring IBC-NSTs. Immunohistochemistry (IHC) of breast tumors with NE differentiation usually shows a hormone receptor (HR)-positive and human epidermal growth factor type 2 (HER2)-negative profile, so that hormonal therapy with cyclin-dependent kinase (CDK)4/6 inhibitors or other targeted agents would be reasonable treatment options. Herein, we present a review of the literature on breast tumors with NE differentiation as defined in the latest WHO 2019 classification, and discuss the clinical management of these tumors.
具有神经内分泌（NE）分化的乳腺肿瘤是一组罕见且异质性的肿瘤，包括具有NE特征的非特殊类型浸润性乳腺癌（IBC-NST）、神经内分泌肿瘤（NET）和神经内分泌癌（NEC）。2019年世界卫生组织（WHO）的最新分类将乳腺神经内分泌肿瘤（Br-NEN）定义为超过90%的细胞显示NE分化组织学证据的肿瘤，包括NET（低级别肿瘤）和NEC（高级别肿瘤）。由于这些肿瘤的发病率较低，且多年来其诊断标准不断变化，目前关于这些肿瘤的证据有限，主要来自病例报告和回顾性病例系列。具有NE分化的乳腺肿瘤通常按照更常见的IBC-NST进行治疗。具有NE分化的乳腺肿瘤的免疫组织化学（IHC）通常显示激素受体（HR）阳性和人表皮生长因子2型（HER2）阴性，因此使用细胞周期蛋白依赖性激酶（CDK）4/6抑制剂或其他靶向药物进行激素治疗将是合理的治疗选择。在此，我们对2019年WHO最新分类中定义的具有NE分化的乳腺肿瘤的文献进行综述，并讨论这些肿瘤的临床管理。
