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Validation of prognostic significance of the proposed uniform classification framework in neuroendocrine neoplasms of the breast

  • Preclinical study
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Abstract

Purpose

A uniform classification framework for neuroendocrine neoplasms (NENs) in all the organ systems has been recently proposed by an International Agency for Research on Cancer (IARC) and World Health Organization (WHO) expert panel. Based on the new classification system, the NENs of the breast are divided into well-differentiated neuroendocrine tumors (NETs) and poorly differentiated neuroendocrine carcinomas (NECs). This study is aimed to analysis the prognostic differences between NENs and invasive ductal carcinomas of no special type (IDCs-NST).

Methods

The surveillance, epidemiology, and end results (SEER) database released on November 2018 was used for this study. Between 2003 and 2016, 361 NENs (NET = 239, NEC = 122) of the breast and 491,908 of IDCs-NST were identified. Survival analysis was performed for disease-specific survival (DSS) and overall survival (OS).

Results

The 5-year DSS of NET, NEC, and IDC-NST was 63.39%, 46.00%, and 89.17%, respectively. And the 5-year OS of NET, NEC, and IDC-NST was 55.66%, 38.87%, and 83.17%, respectively. Within the same clinical stage or grade, NETs and NECs of the breast had worse DSS and OS than corresponding stage or grade IDCs-NST (all P < 0.050). In univariate and multivariate survival analysis, NENs of the breast had significantly worse DSS and OS than IDCs-NST (P < 0.001).

Conclusion

The universal classification framework for NEN allowed us to further refine the breast carcinoma with neuroendocrine differentiation as a unique pathologic and clinical entity, which has worse clinical outcome compared to IDC-NST.

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Abbreviations

NEN:

Neuroendocrine neoplasm

NE:

Neuroendocrine differentiation

NEC:

Neuroendocrine carcinoma

IARC:

International Agency for Research on Cancer

WD-NET:

Well-differentiated neuroendocrine tumor

PD-NEC:

Poorly differentiated neuroendocrine carcinoma

DSS:

Disease-specific survival

OS:

Overall survival

SEER:

Surveillance, epidemiology, and end results

IDC-NST:

Invasive ductal carcinoma of no special type

ER:

Estrogen receptor

HER2:

Human epidermal growth factor receptor type 2

PSM:

Propensity score matching

CI:

Confidential interval

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Authors and Affiliations

  1. Departments of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Libo Yang, Madhuchhanda Roy, Constance Albarracin, Lei Huo, Hui Chen & Yun Wu

  2. Departments of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Heather Lin & Yu Shen

  3. Departments of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Isabelle Bedrosian

  4. Department of Pathology, West China Hospital, Sichuan University, Chengdu, China

    Libo Yang, Bing Wei & Hong Bu

Authors
  1. Libo Yang
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  2. Madhuchhanda Roy
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  3. Heather Lin
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  4. Yu Shen
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  5. Constance Albarracin
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  11. Yun Wu
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Correspondence to Yun Wu.

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Yang, L., Roy, M., Lin, H. et al. Validation of prognostic significance of the proposed uniform classification framework in neuroendocrine neoplasms of the breast. Breast Cancer Res Treat 186, 403–415 (2021). https://doi.org/10.1007/s10549-021-06099-6

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  • DOI: https://doi.org/10.1007/s10549-021-06099-6

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