{"title":"乳腺神经内分泌肿瘤：当前见解与未来方向","authors":"Lei Jiang, Xinyuan Pan, Zhiqiang Lang","doi":"10.1002/cnr2.70059","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>The breast neuroendocrine neoplasms (NENs) represent a heterogeneous group of tumors and account for less than 1% of all NENs. The 5th edition of the WHO Classification of Breast Tumors in 2019 introduced a more stringent definition for breast NENs including neuroendocrine tumors (NETs) (G1, G2) and neuroendocrine carcinomas (NECs) (small cell carcinoma, large cell neuroendocrine carcinoma). While the diagnostic criteria and treatment of breast NENs still have some unsolved issues.</p>\n </section>\n \n <section>\n \n <h3> Objective</h3>\n \n <p>We aim to discuss the diagnosis, treatment progress, existing problems, and future development direction of breast NENs.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>We provide a comprehensive review and evaluation of the diagnostic criteria, pathological features, utilization of immunohistochemical markers, molecular characteristics, pathogenesis, clinical significance, treatment options for breast NENs.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>(1) Under the new definition, \"pure\" breast NENs are extremely rare. (2) Breast NETs are graded according to Nottingham grading System. Grading criteria utilized in other systems for NENs, such as mitotic count, ki67 proliferation index, and necrosis, have not been applied to breast NENs. (3) The WHO has not yet acknowledged the existence of NET G3 clearly. (4) The expression of NE markers may differ in breast NECs. (5) The treatment of breast NENs is still based on IBCs-NST, and without any difference from invasive carcinoma with NE features. (6) The prognosis of breast NENs remains unclear, while the prognosis for NECs is significantly poorer than invasive breast carcinomas of no special type (IBCs-NST) has been confirmed.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>Strict adherence to criteria is the key to correctly diagnose breast NENs with the exclusion of metastasis from other sites. Further exploration is required to determine the tissue origin of breast NENs and understand the pathogenesis. Efforts are still needed to establish unified diagnostic criteria and a unique diagnosis and treatment consensus for breast NENs.</p>\n </section>\n </div>","PeriodicalId":9440,"journal":{"name":"Cancer reports","volume":"7 11","pages":""},"PeriodicalIF":1.5000,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cnr2.70059","citationCount":"0","resultStr":"{\"title\":\"Neuroendocrine Neoplasms of the Breast: Current Insights and Future Directions\",\"authors\":\"Lei Jiang, Xinyuan Pan, Zhiqiang Lang\",\"doi\":\"10.1002/cnr2.70059\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Background</h3>\\n \\n <p>The breast neuroendocrine neoplasms (NENs) represent a heterogeneous group of tumors and account for less than 1% of all NENs. The 5th edition of the WHO Classification of Breast Tumors in 2019 introduced a more stringent definition for breast NENs including neuroendocrine tumors (NETs) (G1, G2) and neuroendocrine carcinomas (NECs) (small cell carcinoma, large cell neuroendocrine carcinoma). While the diagnostic criteria and treatment of breast NENs still have some unsolved issues.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Objective</h3>\\n \\n <p>We aim to discuss the diagnosis, treatment progress, existing problems, and future development direction of breast NENs.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>We provide a comprehensive review and evaluation of the diagnostic criteria, pathological features, utilization of immunohistochemical markers, molecular characteristics, pathogenesis, clinical significance, treatment options for breast NENs.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>(1) Under the new definition, \\\"pure\\\" breast NENs are extremely rare. (2) Breast NETs are graded according to Nottingham grading System. Grading criteria utilized in other systems for NENs, such as mitotic count, ki67 proliferation index, and necrosis, have not been applied to breast NENs. (3) The WHO has not yet acknowledged the existence of NET G3 clearly. (4) The expression of NE markers may differ in breast NECs. (5) The treatment of breast NENs is still based on IBCs-NST, and without any difference from invasive carcinoma with NE features. (6) The prognosis of breast NENs remains unclear, while the prognosis for NECs is significantly poorer than invasive breast carcinomas of no special type (IBCs-NST) has been confirmed.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusion</h3>\\n \\n <p>Strict adherence to criteria is the key to correctly diagnose breast NENs with the exclusion of metastasis from other sites. Further exploration is required to determine the tissue origin of breast NENs and understand the pathogenesis. Efforts are still needed to establish unified diagnostic criteria and a unique diagnosis and treatment consensus for breast NENs.</p>\\n </section>\\n </div>\",\"PeriodicalId\":9440,\"journal\":{\"name\":\"Cancer reports\",\"volume\":\"7 11\",\"pages\":\"\"},\"PeriodicalIF\":1.5000,\"publicationDate\":\"2024-11-25\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cnr2.70059\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Cancer reports\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1002/cnr2.70059\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"ONCOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Cancer reports","FirstCategoryId":"1085","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/cnr2.70059","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"ONCOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
背景 乳腺神经内分泌肿瘤（NENs）是一类异质性肿瘤，占所有 NENs 的比例不到 1%。2019年第五版《世界卫生组织乳腺肿瘤分类》对乳腺神经内分泌肿瘤（NENs）进行了更严格的定义，包括神经内分泌肿瘤（NETs）（G1、G2）和神经内分泌癌（NECs）（小细胞癌、大细胞神经内分泌癌）。虽然乳腺 NENs 的诊断标准和治疗仍存在一些未解决的问题。 目的 探讨乳腺 NEN 的诊断、治疗进展、现存问题及未来发展方向。 方法 对乳腺 NENs 的诊断标准、病理特征、免疫组化标记物的应用、分子特征、发病机制、临床意义、治疗方案等进行全面回顾和评价。 结果 (1) 根据新定义，"纯 "乳腺 NENs 极其罕见。(2）乳腺 NET 根据诺丁汉分级系统进行分级。其他系统对 NENs 采用的分级标准，如有丝分裂计数、ki67 增殖指数和坏死，尚未应用于乳腺 NENs。(3) 世卫组织尚未明确承认 G3 级乳腺癌的存在。(4) 乳腺 NEC 中 NE 标志物的表达可能有所不同。(5) 对乳腺 NEN 的治疗仍以 IBC-NST 为基础，与具有 NE 特征的浸润癌没有任何区别。(6) 乳腺 NEN 的预后仍不明确，而 NEC 的预后明显差于无特殊类型的浸润性乳腺癌（IBCs-NST）已得到证实。 结论 严格遵守标准是正确诊断乳腺 NEN 并排除其他部位转移的关键。要确定乳腺 NEN 的组织来源并了解其发病机制，还需要进一步探索。目前仍需努力为乳腺 NENs 建立统一的诊断标准，并达成独特的诊断和治疗共识。
Neuroendocrine Neoplasms of the Breast: Current Insights and Future Directions
Background
The breast neuroendocrine neoplasms (NENs) represent a heterogeneous group of tumors and account for less than 1% of all NENs. The 5th edition of the WHO Classification of Breast Tumors in 2019 introduced a more stringent definition for breast NENs including neuroendocrine tumors (NETs) (G1, G2) and neuroendocrine carcinomas (NECs) (small cell carcinoma, large cell neuroendocrine carcinoma). While the diagnostic criteria and treatment of breast NENs still have some unsolved issues.
Objective
We aim to discuss the diagnosis, treatment progress, existing problems, and future development direction of breast NENs.
Methods
We provide a comprehensive review and evaluation of the diagnostic criteria, pathological features, utilization of immunohistochemical markers, molecular characteristics, pathogenesis, clinical significance, treatment options for breast NENs.
Results
(1) Under the new definition, "pure" breast NENs are extremely rare. (2) Breast NETs are graded according to Nottingham grading System. Grading criteria utilized in other systems for NENs, such as mitotic count, ki67 proliferation index, and necrosis, have not been applied to breast NENs. (3) The WHO has not yet acknowledged the existence of NET G3 clearly. (4) The expression of NE markers may differ in breast NECs. (5) The treatment of breast NENs is still based on IBCs-NST, and without any difference from invasive carcinoma with NE features. (6) The prognosis of breast NENs remains unclear, while the prognosis for NECs is significantly poorer than invasive breast carcinomas of no special type (IBCs-NST) has been confirmed.
Conclusion
Strict adherence to criteria is the key to correctly diagnose breast NENs with the exclusion of metastasis from other sites. Further exploration is required to determine the tissue origin of breast NENs and understand the pathogenesis. Efforts are still needed to establish unified diagnostic criteria and a unique diagnosis and treatment consensus for breast NENs.
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