Faculty Collaboration Database

Primary Breast Neuroendocrine Tumors: An Analysis of the National Cancer Database. Ann Surg Oncol 2022 Oct;29(10):6339-6346

Date

07/06/2022

Pubmed ID

35789311

Pubmed Central ID

PMC9464685

DOI

10.1245/s10434-022-12123-w

Scopus ID

2-s2.0-85133397784 (requires institutional sign-in at Scopus site)   8 Citations

Abstract

BACKGROUND: Primary breast neuroendocrine tumors (BNETs) represent < 1% of breast cancers. Diagnosing BNETs can be challenging, and a limited amount of cohort data currently exists in literature. We aimed to describe primary BNET characteristics, treatment modalities, and survival outcomes through the National Cancer Database (NCDB).

METHODS: A retrospective cohort analysis was performed using the NCDB from 2004 to 2017. BNET cases were compared with patients with invasive ductal carcinoma (IDC). A matched IDC cohort was created by matching patient age, race, and disease stage. Kaplan-Meier analysis was performed, and hazard ratios (HR) were calculated through the bootstrap sampling method.

RESULTS: A total of 1389 BNET and 1,967,401 IDC cases were identified. When compared with IDC patients, BNET patients were older, had more comorbidities, and were more often male (p < 0.01). BNETs were larger, higher grade, and more frequently hormone receptor negative (p < 0.01). While BNET patients were treated with surgery and radiotherapy (p < 0.01) less often compared with IDC patients, they presented at later disease stage (p < 0.001) and received systemic treatment more frequently (53.5% vs. 40%, p < 0.01). Patients with BNET had increased mortality compared with the matched IDC cohort: stage 1 HR 1.8, stage 2 HR 2.0, stage 3 HR 1.8, and stage 4 HR 1.5 (p < 0.001 for all).

CONCLUSION: Patients with BNET tend to present at higher clinical stages, are more frequently hormone receptor negative, and have inferior overall survival compared with patients with IDC. Further treatment strategies and studies are needed to elucidate optimal therapies to maximize patient outcomes.

Author List

Martinez EO, Jorns JM, Kong AL, Kijak J, Lee WY, Huang CC, Cortina CS

Authors

Chandler S. Cortina MD Assistant Professor in the Surgery department at Medical College of Wisconsin
Julie M. Jorns MD Professor in the Pathology department at Medical College of Wisconsin
Amanda L. Kong MD, MS Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Breast Neoplasms
Carcinoma, Ductal, Breast
Hormones
Humans
Male
Neuroendocrine Tumors
Retrospective Studies