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Neuroendocrine carcinoma of the breast (NECB) is a subtype of breast cancer. The diagnostic criteria of primary NECB were established in 2003 and updated in 2012. It is a rare entity, and few studies have reported the histogenesis, immunohistochemistry for a pathological diagnosis, clinical behavior, therapeutic strategies, and the prognostic facto...
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Purpose
To test the effect of 3D printed implants, designed according to surgeon’s individual plan, on the accuracy of reduction of an acetabular fracture model.
Methods
Seven identical standardized plastic bone models of an anterior column/posterior hemi-transverse acetabular fracture were used. A CT of one plastic fracture model was made. Using...
Citations
... Currently, surgical intervention is the mainstay of the therapeutic approach (5,6). Treatment strategies are chosen dependent on Classification of Malignant Tumors (TNM) status, aggressiveness, age, general condition, and comorbidities of the patient (7). If (neo-)adjuvant chemotherapy is necessary, NEBC is being treated either analog to adenocarcinomas of the breast or SCLC (8,9). ...
... If (neo-)adjuvant chemotherapy is necessary, NEBC is being treated either analog to adenocarcinomas of the breast or SCLC (8,9). Previously, Ki67 was used as a decision tool in NEBC; Ki67 < 15% led to a breast cancer analog therapy, i > 15% of the therapy was orientated to SCLC/neuroendocrine treatment (7). Promising results were seen when a combination of surgery, radiotherapy, and chemotherapy was applied (6). ...
Neuroendocrine breast cancer (NEBC) is a rare entity accounting for <0.1% of all breast carcinomas and <0.1% of all neuroendocrine carcinomas. In most cases treatment strategies in NEBC are empirical in absence of prospective trial data on NEBC cohorts. Herein, we present two case reports diagnosed with anaplastic and small cell NEBC. After initial therapies failed, comprehensive tumor profiling was applied, leading to individualized treatment options for both patients. In both patients, targetable alterations of the PI3K/AKT/mTOR pathway were found, including a PIK3CA mutation itself and an STK11 mutation that negatively regulates the mTOR complex. The epicrisis of the two patients exemplifies how to manage rare and difficult to treat cancers and how new diagnostic tools contribute to medical management.
Background: Small-cell carcinoma of the breast is a rare disease with little research outlining molecular targets or optimal therapeutic management. We summarize a young female patient with poorly differentiated high-grade carcinoma with neuroendocrine features/small-cell carcinoma. Case presentation: A 31-year-old female presented with a large left breast mass. Initial biopsy revealed small-cell, triple-negative breast carcinoma. Treatment consisted of cisplatin and etoposide but was poorly tolerated and discontinued after one cycle. Combination abraxane/atezolizumab resulted in transient partial response in tumor size with 7 months of progression-free stability. Worsening metastatic disease was found 8 months after initial biopsy on radiologic studies and the patient expired 10 months after initial biopsy. Conclusion: Transient benefit in response to combination abraxane/atezolizumab was demonstrated.
Merkel cell carcinoma (MCC) of the breast is a very rare and aggressive type of neuroendocrine carcinoma of the breast (NECB) that typically occurs in older and immunocompromised individuals often presenting as a large palpable mass (Albright et al., 2018¹). Imaging features of MCC are similar to other NECBs, typically appearing as an oval circumscribed mass on mammography and as an irregular mass with increased vascularity on sonography (Jeon et al., 2014²). While both MCC and primary NECB demonstrate positive immunostaining for synaptophysin, obtaining immunohistochemical stains for specific markers, such as CK7 and CK20 is imperative to confirm the diagnosis of MCC (Albright et al., 2018¹). We present a case of a 57-year-old female patient with no personal or family history of breast cancer, who presented for evaluation of a palpable abnormality in her left breast. Initial diagnostic mammogram demonstrated a circumscribed mass in the upper outer quadrant of the left breast corresponding to the palpable area of concern, which correlated to an irregular mass with increased vascularity on targeted ultrasound, similar to other NECBs. Pathologic results after tissue sampling yielded poorly differentiated primary NECB. Following neoadjuvant chemotherapy, the patient underwent a lumpectomy and further immunohistochemical stains of the lumpectomy specimen demonstrated diffusely positive synaptophysin, negative CK7, and positive CK20, consistent with MCC of the breast.
Primary neuroendocrine breast tumors account for less than 0.1% of all breast cancers, hence, unique in nature. This paper aims to report a 56 years old female, known case of primary neuroendocrine breast cancer with a metastatic right colonic neuro-endocrine tumor. The article also aims to review and acclaim the literature regarding primary
breast neuroendocrine tumors metastasized to other parts of the body. The patient presented complaining of a breast mass, ulceration, and discharge, which was rapidly progressing. Examination revealed a right breast mass with skin erythema and impending ulceration and right axillary lymph nodes fixed with palpable supra-clavicular lymph nodes. Ultrasound-guided biopsy of right breast mass and axilla disclosed a large cell neuroendocrine carcinoma. CT abdomen and chest revealed metastases to the ascending colon. The patient was treated with palliative radiotherapy along with multiple cycles of chemotherapy for the primary breast cancer. She also underwent a laparoscopic-assisted
right hemicolectomy with complete mesocolic excision and primary anastomosis for the metastatic colon cancer. The paper compares the reported case to other similar cases using the framework of an analysis based on age of the patient, primary breast cancer location, method of detection, presence of neuroendocrine markers, primary cancer
presentation, metastases symptoms, and location and treatment approach. In conclusion, metastasized primary neuroendocrine breast cancer is a very rare presentation. Incidence and prevalence maybe influenced by age, primary breast cancer location, and presence of neuroendocrine markers. Prognosis may also be a product of metastatic location, associated symptoms and treatment approaches.
Objective:
We aimed to evaluate the diagnostic impact of 18F-FDG PET/CT in staging apocrine breast carcinoma (ABC) and primary breast neuroendocrine carcinoma (PBNEC) and to demonstrate possible alterations of the 18F-FDG uptake in these histopathologic subtypes. In addition, we aimed to compare 18F-FDG PET/CT findings between ABC, PBNEC and invasive ductal carcinoma.
Material and methods:
A total of 570 patients and 585 breast lesions were retrospectively included in this study. After patients were classified into molecular subtypes according to the histopathological analysis, 18F-FDG PET/CT imaging was performed. The SUVmax findings of primary tumors obtained from 18F-FDG PET/CT were compared between the groups.
Results:
Invasive ductal carcinoma was the most prevalent breast carcinoma (77.7%, n=446), with a low proportion of ABC (4.1%, n=24) and PBNEC (2.4%; n=14) diagnosed. The highest mean SUVmax was calculated in HER2 subtype of ABC and 18F-FDG uptake ratio in HER2 and TN subtypes were found statistically higher than Luminal B type of ABC (p=0.038 and p=0.019, respectively). Although 18F-FDG uptake in Luminal B subtype of PBNEC was higher than Luminal A subtype, difference was not statistically significant. Additionally, the axillary metastasis rate was significantly higher in the ABC group (p=0.015).
Conclusions:
The histopathological ABC subtype group showed different 18F-FDG uptake than the invasive ductal carcinoma group. Even if 18F-FDG uptake was lower in the PBNEC group than in the other groups, PET/CT showed and adequate performance in detecting primary tumors and metastases. The 18F-FDG PET/CT scan results may contribute to the initial staging and management of ABC and PBNEC patients.
Abstract
Objective
We aimed to evaluate the diagnostic impact of 18F-FDG PET/CT in staging apocrine breast carcinoma (ABC) and primary breast neuroendocrine carcinoma (PBNEC) and to demonstrate possible alterations of the 18F-FDG uptake in these histopathologic subtypes. In addition, we aimed to compare 18F-FDG PET/CT findings between ABC, PBNEC and invasive ductal carcinoma (IDC).
Material and methods
A total of 570 patients and 585 breast lesions were retrospectively included in this study. After patients were classified into molecular subtypes according to the histopathological analysis, 18F-FDG PET/CT imaging was performed. The SUVmax findings of primary tumors obtained from 18F-FDG PET/CT were compared between the groups.
Results
IDC was the most prevalent breast carcinoma (77.7%, n = 446), with a low proportion of ABC (4.1%, n = 24) and PBNEC (2.4%; n = 14) diagnosed. The highest mean SUVmax was calculated in HER2 subtype of ABC and 18F-FDG uptake ratio in HER2 and TN subtypes were found statistically higher than Luminal B type of ABC (p = 0.038 and p = 0.019, respectively). Although 18F-FDG uptake in Luminal B subtype of PBNEC was higher than Luminal A subtype, difference was not statistically significant. Additionally, the axillary metastasis rate was significantly higher in the ABC group (p = 0.015).
Conclusions
The histopathological ABC subtype group showed different 18F-FDG uptake than the IDC group. Even if 18F-FDG uptake was lower in the PBNEC group than in the other groups, PET/CT showed and adequate performance in detecting primary tumors and metastases. The 18F-FDG PET/CT scan results may contribute to the initial staging and management of ABC and PBNEC patients.
