title: Neuroendocrine differentiation and prognosis in breast adenocarcinoma.
abstract: OBJECTIVE
  Neuroendocrine differentiation has been detected, and its prognostic value studied, in a number of common human carcinomas. To date there are few detailed studies examining its relevance in breast carcinoma. In this study we evaluate the frequency and prognostic importance of neuroendocrine differentiation in breast adenocarcinoma.
  
  
  RESULTS
  The presence of neuroendocrine differentiation, defined as positive reactivity for three markers, neuron-specific enolase (NSE), chromogranin A and/or synaptophysin, has been evaluated in 99 patients with primary operable breast cancer using standard immunocytochemical techniques. A consecutive cohort of patients were selected from the Nottingham/Tenovus series. Comprehensive patient and tumour records have been maintained, and patients were followed up according to a defined protocol. Eighteen cases were positive for NSE, 10 for chromogranin A and 13 for synaptophysin. Eleven percent were positive with more than one neuroendocrine marker. No significant association was found between neuroendocrine differentiation and tumour size, grade, stage or the prevalence of vascular invasion. There was no significant difference in either overall or disease-free survival between patients with or without neuroendocrine differentiation.
  
  
  CONCLUSIONS
  In this study we confirm that neuroendocrine differentiation can be identified in a subset (10-18%) of human breast carcinomas. This phenomenon appears to have no relationship to established prognostic factors or patient outcome.
authors.affiliation: Department of Histopathology, Nottingham City Hospital, Nottingham, UK.
authors.forename: A
authors.initials: A
authors.lastname: Miremadi
authors.forename: S E
authors.initials: SE
authors.lastname: Pinder
authors.forename: A H S
authors.initials: AH
authors.lastname: Lee
authors.forename: J A
authors.initials: JA
authors.lastname: Bell
authors.forename: E C
authors.initials: EC
authors.lastname: Paish
authors.forename: P
authors.initials: P
authors.lastname: Wencyk
authors.forename: C W
authors.initials: CW
authors.lastname: Elston
authors.forename: R I
authors.initials: RI
authors.lastname: Nicholson
authors.forename: R W
authors.initials: RW
authors.lastname: Blamey
authors.forename: J F
authors.initials: JF
authors.lastname: Robertson
authors.forename: I O
authors.initials: IO
authors.lastname: Ellis
mesh_terms: D000230:Adenocarcinoma / Q000378:metabolism / Q000473:pathology*; D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000378:metabolism / Q000473:pathology*; D018278:Carcinoma, Neuroendocrine / Q000378:metabolism / Q000473:pathology*; D053379:Chromogranin A; D002864:Chromogranins / Q000032:analysis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D008875:Middle Aged; D010751:Phosphopyruvate Hydratase / Q000032:analysis; D011379:Prognosis; D016019:Survival Analysis; D016708:Synaptophysin / Q000032:analysis
chemical_list: D053379:Chromogranin A; D002864:Chromogranins; D016708:Synaptophysin; D010751:Phosphopyruvate Hydratase