Neuroendocrine differentiation in breast carcinoma: clinicopathological features and outcome

Abstract

Aims Primary neuroendocrine (NE) breast carcinoma (BC) is an entity with a wide range of prevalence and poorly defined clinical behaviour. We evaluated the prevalence, clinicopathological features and clinical outcome of NEBC. Methods and results Immunohistochemical staining for synaptophysin and chromogranin A was performed on whole sections from 1232 consecutive cases of invasive BC. We divided NEBC into focal (10–49% positive cells) and diffuse (≥50% positive cells) and compared the outcome of patients with NEBC with strictly matched non‐NEBC. A total of 128 BC showed NE differentiation (10.4%): 84 diffuse (6.8%) and 44 focal (3.6%). NE differentiation showed a significant association with T4 stage (P = 0.001), solid‐papillary and mucinous histotype (P < 0.0001), G2 grading (P = 0.002), positive oestrogen receptor (ER) (P = 0.003) and progesterone receptor (PR) (P = 0.002). Almost 90% of NEBC were ER⁺/HER2⁻ and more than half ER⁺/HER2⁻/Ki67≥14%. Kaplan–Meier analysis revealed that patients with NEBC showed worse disease‐free survival (DFS) (P = 0.04) compared to matched non‐NEBC. We did not find significant differences regarding clinicopathological features, DFS and CSS between diffuse and focal neuroendocrine BC. Conclusions This study demonstrates that NEBC represents 7–10% of invasive BC and that NE differentiation does not affect the prognosis of BC in terms of CSS.