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Open Access Highly Accessed Research article

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

Jun Wang13, Bing Wei23, Constance T Albarracin3, Jianhua Hu4, Susan C Abraham3 and Yun Wu3*

Author Affiliations

1 Department of Oncology, General Hospital, Jinan Command of the People’s Liberation Army, Jinan, China

2 Department of Pathology, West China Hospital, Sichuan University, Chengdu, China

3 Department of Pathology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, USA

4 Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

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BMC Cancer 2014, 14:147  doi:10.1186/1471-2407-14-147

Published: 4 March 2014

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.

Keywords:
Neuroendocrine carcinoma; Endocrine carcinoma; Invasive carcinoma; Breast; SEER registry