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Vegni F, De Stefano IS, Policardo F, Tralongo P, Feraco A, Carlino A, Ferraro G, Zhang Q, Scaglione G, D'Alessandris N, Navarra E, Zannoni G, Santoro A, Mule A, Rossi ED. Neuroendocrine neoplasms of the breast: a review of literature. Virchows Arch 2024; 485:197-212. [PMID: 38980337 PMCID: PMC11329594 DOI: 10.1007/s00428-024-03856-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2024] [Revised: 06/14/2024] [Accepted: 06/18/2024] [Indexed: 07/10/2024]
Abstract
Primary neuroendocrine neoplasms (NENs) of the breast are characterized by neuroendocrine architectural and cytological features, which must be supported by immunohistochemical positivity for neuroendocrine markers (such as Chromogranin and Synaptophysin). According to the literature, making a diagnosis of primary neuroendocrine breast cancer always needs to rule out a possible primary neuroendocrine neoplasm from another site. Currently, the latest 2022 version of the WHO of endocrine and neuroendocrine neoplasms has classified breast NENs as well-differentiated neuroendocrine tumours (NETs) and aggressive neuroendocrine carcinomas (NECs), differentiating them from invasive breast cancers of no special type (IBCs-NST). with neuroendocrine features. The current review article describes six cases from our series and a comprehensive review of the literature in the field of NENs of the breast.
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Affiliation(s)
- Federica Vegni
- Division of Anatomic Pathology and Histology-Fondazione, Policlinico Universitario "Agostino Gemelli"-IRCCS, Università Cattolica del Sacro Cuore, Largo Francesco Vito, 1, 00168, Rome, Italy
| | - Ilenia Sara De Stefano
- Division of Anatomic Pathology and Histology-Fondazione, Policlinico Universitario "Agostino Gemelli"-IRCCS, Università Cattolica del Sacro Cuore, Largo Francesco Vito, 1, 00168, Rome, Italy
| | - Federica Policardo
- Division of Anatomic Pathology and Histology-Fondazione, Policlinico Universitario "Agostino Gemelli"-IRCCS, Università Cattolica del Sacro Cuore, Largo Francesco Vito, 1, 00168, Rome, Italy
| | - Pietro Tralongo
- Division of Anatomic Pathology and Histology-Fondazione, Policlinico Universitario "Agostino Gemelli"-IRCCS, Università Cattolica del Sacro Cuore, Largo Francesco Vito, 1, 00168, Rome, Italy
| | - Angela Feraco
- Division of Anatomic Pathology and Histology-Fondazione, Policlinico Universitario "Agostino Gemelli"-IRCCS, Università Cattolica del Sacro Cuore, Largo Francesco Vito, 1, 00168, Rome, Italy
| | - Angela Carlino
- Division of Anatomic Pathology and Histology-Fondazione, Policlinico Universitario "Agostino Gemelli"-IRCCS, Università Cattolica del Sacro Cuore, Largo Francesco Vito, 1, 00168, Rome, Italy
| | - Giulia Ferraro
- Division of Anatomic Pathology and Histology-Fondazione, Policlinico Universitario "Agostino Gemelli"-IRCCS, Università Cattolica del Sacro Cuore, Largo Francesco Vito, 1, 00168, Rome, Italy
| | - Qianqian Zhang
- Division of Anatomic Pathology and Histology-Fondazione, Policlinico Universitario "Agostino Gemelli"-IRCCS, Università Cattolica del Sacro Cuore, Largo Francesco Vito, 1, 00168, Rome, Italy
| | - Giulia Scaglione
- Division of Anatomic Pathology and Histology-Fondazione, Policlinico Universitario "Agostino Gemelli"-IRCCS, Università Cattolica del Sacro Cuore, Largo Francesco Vito, 1, 00168, Rome, Italy
| | - Nicoletta D'Alessandris
- Division of Anatomic Pathology and Histology-Fondazione, Policlinico Universitario "Agostino Gemelli"-IRCCS, Università Cattolica del Sacro Cuore, Largo Francesco Vito, 1, 00168, Rome, Italy
| | - Elena Navarra
- Division of Anatomic Pathology and Histology-Fondazione, Policlinico Universitario "Agostino Gemelli"-IRCCS, Università Cattolica del Sacro Cuore, Largo Francesco Vito, 1, 00168, Rome, Italy
| | - Gianfranco Zannoni
- Division of Anatomic Pathology and Histology-Fondazione, Policlinico Universitario "Agostino Gemelli"-IRCCS, Università Cattolica del Sacro Cuore, Largo Francesco Vito, 1, 00168, Rome, Italy
| | - Angela Santoro
- Division of Anatomic Pathology and Histology-Fondazione, Policlinico Universitario "Agostino Gemelli"-IRCCS, Università Cattolica del Sacro Cuore, Largo Francesco Vito, 1, 00168, Rome, Italy
| | - Antonino Mule
- Division of Anatomic Pathology and Histology-Fondazione, Policlinico Universitario "Agostino Gemelli"-IRCCS, Università Cattolica del Sacro Cuore, Largo Francesco Vito, 1, 00168, Rome, Italy
| | - Esther Diana Rossi
- Division of Anatomic Pathology and Histology-Fondazione, Policlinico Universitario "Agostino Gemelli"-IRCCS, Università Cattolica del Sacro Cuore, Largo Francesco Vito, 1, 00168, Rome, Italy.
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Huang Y, Wang G, Zhang N, Zeng X. MAP3K4 kinase action and dual role in cancer. Discov Oncol 2024; 15:99. [PMID: 38568424 PMCID: PMC10992237 DOI: 10.1007/s12672-024-00961-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Accepted: 03/29/2024] [Indexed: 04/06/2024] Open
Abstract
It is commonly known that the MAPK pathway is involved in translating environmental inputs, regulating downstream reactions, and maintaining the intrinsic dynamic balance. Numerous essential elements and regulatory processes are included in this pathway, which are essential to its functionality. Among these, MAP3K4, a member of the serine/threonine kinases family, plays vital roles throughout the organism's life cycle, including the regulation of apoptosis and autophagy. Moreover, MAP3K4 can interact with key partners like GADD45, which affects organism's growth and development. Notably, MAP3K4 functions as both a tumor promotor and suppressor, being activated by a variety of factors and triggering diverse downstream pathways that differently influence cancer progression. The aim of this study is to provide a brief overview of physiological functions of MAP3K4 and shed light on its contradictory roles in tumorigenesis.
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Affiliation(s)
- Yuxin Huang
- Department of Breast Cancer Center, Chongqing University Cancer Hospital, School of Medicine, Chongqing University, Chongqing, China
| | - Guanwen Wang
- Department of Breast Cancer Center, Chongqing University Cancer Hospital, Chongqing, China
| | - Ningning Zhang
- Department of Breast Cancer Center, Chongqing University Cancer Hospital, Chongqing, China.
| | - Xiaohua Zeng
- Department of Breast Cancer Center, Chongqing University Cancer Hospital, School of Medicine, Chongqing University, Chongqing, China.
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Bean GR, Najjar S, Shin SJ, Hosfield EM, Caswell-Jin JL, Urisman A, Jones KD, Chen YY, Krings G. Genetic and immunohistochemical profiling of small cell and large cell neuroendocrine carcinomas of the breast. Mod Pathol 2022; 35:1349-1361. [PMID: 35590107 PMCID: PMC9514991 DOI: 10.1038/s41379-022-01090-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 04/13/2022] [Accepted: 04/14/2022] [Indexed: 11/09/2022]
Abstract
Neuroendocrine carcinomas (NEC) of the breast are exceedingly rare tumors, which are classified in the WHO system as small cell (SCNEC) and large cell (LCNEC) carcinoma based on indistinguishable features from their lung counterparts. In contrast to lung and enteropancreatic NEC, the genomics of breast NEC have not been well-characterized. In this study, we examined the clinicopathologic, immunohistochemical, and genetic features of 13 breast NEC (7 SCNEC, 4 LCNEC, 2 NEC with ambiguous small versus large cell morphology [ANEC]). Co-alterations of TP53 and RB1 were identified in 86% (6/7) SCNEC, 100% (2/2) ANEC, and 50% (2/4) LCNEC. The one SCNEC without TP53/RB1 alteration had other p53 pathway aberrations (MDM2 and MDM4 amplification) and was immunohistochemically RB negative. PIK3CA/PTEN pathway alterations and ZNF703 amplifications were each identified in 46% (6/13) NEC. Two tumors (1 SCNEC, 1 LCNEC) were CDH1 mutated. By immunohistochemistry, 100% SCNEC (6/6) and ANEC (2/2) and 50% (2/4) LCNEC (83% NEC) showed RB loss, compared to 0% (0/8) grade 3 neuroendocrine tumors (NET) (p < 0.001) and 38% (36/95) grade 3 invasive ductal carcinomas of no special type (IDC-NST) (p = 0.004). NEC were also more often p53 aberrant (60% vs 0%, p = 0.013), ER negative (69% vs 0%, p = 0.005), and GATA3 negative (67% vs 0%, p = 0.013) than grade 3 NET. Two mixed NEC had IDC-NST components, and 69% (9/13) of tumors were associated with carcinoma in situ (6 neuroendocrine DCIS, 2 non-neuroendocrine DCIS, 1 non-neuroendocrine LCIS). NEC and IDC-NST components of mixed tumors were clonally related and immunophenotypically distinct, lacking ER and GATA3 expression in NEC relative to IDC-NST, with RB loss only in NEC of one ANEC. The findings provide insight into the pathogenesis of breast NEC, underscore their classification as a distinct tumor type, and highlight genetic similarities to extramammary NEC, including highly prevalent p53/RB pathway aberrations in SCNEC.
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Affiliation(s)
- Gregory R. Bean
- grid.168010.e0000000419368956Department of Pathology, Stanford University School of Medicine, Stanford, CA USA
| | - Saleh Najjar
- grid.168010.e0000000419368956Department of Pathology, Stanford University School of Medicine, Stanford, CA USA
| | - Sandra J. Shin
- grid.413558.e0000 0001 0427 8745Department of Pathology and Laboratory Medicine, Albany Medical College, Albany, NY USA
| | - Elizabeth M. Hosfield
- grid.414890.00000 0004 0461 9476Department of Pathology, Kaiser Permanente San Francisco Medical Center, San Francisco, CA USA
| | - Jennifer L. Caswell-Jin
- grid.168010.e0000000419368956Department of Medicine, Division of Oncology, Stanford University School of Medicine, Stanford, CA USA
| | - Anatoly Urisman
- grid.266102.10000 0001 2297 6811Department of Pathology, University of California San Francisco, San Francisco, CA USA
| | - Kirk D. Jones
- grid.266102.10000 0001 2297 6811Department of Pathology, University of California San Francisco, San Francisco, CA USA
| | - Yunn-Yi Chen
- grid.266102.10000 0001 2297 6811Department of Pathology, University of California San Francisco, San Francisco, CA USA
| | - Gregor Krings
- Department of Pathology, University of California San Francisco, San Francisco, CA, USA.
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Ozaki Y, Miura S, Oki R, Morikawa T, Uchino K. Neuroendocrine Neoplasms of the Breast: The Latest WHO Classification and Review of the Literature. Cancers (Basel) 2021; 14:cancers14010196. [PMID: 35008357 PMCID: PMC8750232 DOI: 10.3390/cancers14010196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Revised: 12/28/2021] [Accepted: 12/28/2021] [Indexed: 11/23/2022] Open
Abstract
Simple Summary Breast tumors exhibiting neuroendocrine differentiation are a heterogeneous group of tumors that have been variously defined in previous World Health Organization (WHO) classifications. In the WHO Classification of Tumours, 5th edition, neuroendocrine tumors (NETs) and neuroendocrine carcinomas (NECs) of the breast, both of which are invasive cancers, are classified as neuroendocrine neoplasms (NENs) of the breast. However, the clinical significance of NE differentiation in breast cancers, especially in NETs of the breast, is not yet fully understood, and a large overlap appears to exist between breast cancers showing NE differentiation and invasive breast cancer of no special type (IBC-NST). While breast NECs show distinct clinical and morphological features, diagnosis of NETs based on the morphological characteristics alone can be challenging; one reason is that breast NETs do not necessarily have the same morphological characteristics as those of NENs arising in other organs. Thus, the heterogeneity of breast tumors with neuroendocrine differentiation and the changes in their classifications over the years have left many open issues that still need to be resolved. In this review, we shall summarize the history of breast “NENs,” including of mixed types of tumors and the characteristics of these tumors, and discuss their differences from NENs arising in other organs. Abstract Breast tumors with neuroendocrine (NE) differentiation comprise an uncommon and heterogeneous group of tumors, including invasive breast cancer of no special type (IBC-NST) with NE features, neuroendocrine tumors (NETs), and neuroendocrine carcinoma (NEC). The most recent World Health Organization (WHO) classification in 2019 defined neuroendocrine neoplasms (NENs) of the breast (Br-NENs) as tumors in which >90% of cells show histological evidence of NE differentiation, including NETs (low-grade tumors) and NEC (high-grade). Due to the low prevalence of these tumors and successive changes in their diagnostic criteria over the years, only limited evidence of these tumors exists, derived mainly from case reports and retrospective case series. Breast tumors with NE differentiation are usually treated like the more commonly occurring IBC-NSTs. Immunohistochemistry (IHC) of breast tumors with NE differentiation usually shows a hormone receptor (HR)-positive and human epidermal growth factor type 2 (HER2)-negative profile, so that hormonal therapy with cyclin-dependent kinase (CDK)4/6 inhibitors or other targeted agents would be reasonable treatment options. Herein, we present a review of the literature on breast tumors with NE differentiation as defined in the latest WHO 2019 classification, and discuss the clinical management of these tumors.
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Affiliation(s)
- Yukinori Ozaki
- Department of Medical Oncology, NTT Medical Center Tokyo, Tokyo 141-8625, Japan; (R.O.); (K.U.)
- Department of Breast Medical Oncology, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo 135-8550, Japan
- Correspondence: ; Tel.: +81-3-3520-0111
| | - Sakiko Miura
- Department of Diagnostic Pathology, NTT Medical Center Tokyo, Tokyo 141-8625, Japan; (S.M.); (T.M.)
| | - Ryosuke Oki
- Department of Medical Oncology, NTT Medical Center Tokyo, Tokyo 141-8625, Japan; (R.O.); (K.U.)
- Department of Medical Oncology, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo 135-8550, Japan
| | - Teppei Morikawa
- Department of Diagnostic Pathology, NTT Medical Center Tokyo, Tokyo 141-8625, Japan; (S.M.); (T.M.)
| | - Keita Uchino
- Department of Medical Oncology, NTT Medical Center Tokyo, Tokyo 141-8625, Japan; (R.O.); (K.U.)
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