Jeon Youngkyung, Kim Ji-Yeon, Ahn Jin Seok, Im Young-Hyuck, Choi Kyuehee, Jeong Sun Young, Jung Yeji, Jang Jaeyeon, Choi Dae-Ho, Hong Joohyun, Kim Hyo Jung, Cho Soo Youn, Park Yeon Hee
Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Division of Medical Oncology and Hematology, Department of Internal Medicine, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Republic of Korea.
Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Cancer Treat Res Commun. 2024;42:100857. doi: 10.1016/j.ctarc.2024.100857. Epub 2024 Dec 12.
The World Health Organization's fifth edition of tumor series classification was published in 2019 and adopted the term 'Neuroendocrine neoplasm (NEN)' to encompass all tumor classes with predominant neuroendocrine differentiation (NED). Based on the updated classification of the NEN, we conducted a case series using the Clinical Data Warehouse platform of SMC.
In this retrospective study, breast NENs and invasive breast carcinomas no special type (IBCNST) with NED, were defined as 'NENS'. Based on pathology slide findings, a pathologist reclassified the diagnoses. Clinical presentation, tumor characteristics, and clinical outcomes of breast 'NENS' were reviewed retrospectively.
A total of 34,370 patients were diagnosed with breast cancer from 1995 to 2022 in SMC, and 14 (0.04 %) patients were diagnosed with breast 'NENS': eight NECs, three NETs, and three IBCNST with NED. The patients' median age was 48.5 years. All patients were treated with curative intent surgery; five patients received neoadjuvant chemotherapy, twelve patients received radiotherapy, six patients received adjuvant chemotherapy, and eight patients received hormone therapy. The median follow-up period for the eight patients with breast NEC was 20.4 months. The median disease-free and overall survival were 14.2 months and 23.6 months, respectively. Patients with NET or IBCNST with NED (n = 6) had an overall favorable outcome, with no deaths, with only one case of disease recurrence.
The incidence of primary breast NENS' was very low (0.04 %) in this single-center study. Among them, primary breast NEC was associated with poor overall survival. Novel treatments are thus required to improve the prognosis of primary breast NEC.
世界卫生组织肿瘤系列分类的第五版于2019年出版，采用了“神经内分泌肿瘤（NEN）”这一术语来涵盖所有以神经内分泌分化（NED）为主的肿瘤类别。基于NEN的更新分类，我们使用SMC的临床数据仓库平台进行了一项病例系列研究。
在这项回顾性研究中，乳腺NENs和具有NED的非特殊类型浸润性乳腺癌（IBCNST）被定义为“NENS”。根据病理切片结果，病理学家对诊断进行了重新分类。对乳腺“NENS”的临床表现、肿瘤特征和临床结局进行了回顾性分析。
1995年至2022年期间，SMC共有34370例患者被诊断为乳腺癌，其中14例（0.04%）患者被诊断为乳腺“NENS”：8例神经内分泌癌（NEC）、3例神经内分泌瘤（NET）和3例具有NED的IBCNST。患者的中位年龄为48.5岁。所有患者均接受了根治性手术治疗；5例患者接受了新辅助化疗，12例患者接受了放疗，6例患者接受了辅助化疗，8例患者接受了激素治疗。8例乳腺NEC患者的中位随访期为20.4个月。无病生存期和总生存期的中位数分别为14.2个月和23.6个月。NET或具有NED的IBCNST患者（n = 6）总体预后良好，无死亡病例，仅有1例疾病复发。
在这项单中心研究中，原发性乳腺NENS的发病率非常低（0.04%）。其中，原发性乳腺NEC与较差的总生存期相关。因此，需要新的治疗方法来改善原发性乳腺NEC的预后。
