title: [Primary neuroendocrine tumors of the breast: a retrospective study of 21 cases and literature review].
abstract: OBJECTIVE
  The aim of the present study was to discuss the epidemiology, clinical and pathologic features, treatment, and prognosis of primary neuroendocrine carcinomas of the breast.
  
  
  METHODS
  We report 21 cases diagnosed over a period of 12 years (1995-2011) at the university hospital of Sfax. A review of the clinical data with pathology and immunohistochemistry study was carried out for all the cases.
  
  
  RESULTS
  The average age was 62 years (34-86 years). At the time of the diagnosis, tumours were classified T1 and T2 (16 cases), N1 (11 cases) and M1 in two cases. The histological examination has shown 13 cases of solid neuroendocrine carcinoma, six cases of large cell type and two cases of atypical carcinoid. Grade I and II SBR were found in 18 cases. Eighty-one percent of the tumours were reactive for synaptophysin; all tumours were positive for chromogranin. Thirteen (61.9%) tumours were estrogen receptor-positive and 12 (57.5%) progesterone receptor-positive. Nineteen (90.5%) tumours were negative for HER2/neu. Overall five-year survival was 72.7%. All patients had surgical treatment with modified radical mastectomy in 13 cases. Adjuvant treatment was indicated according to histopronostic elements.
  
  
  CONCLUSIONS
  For primary neuroendocrine carcinoma of the breast, multivariate analysis identified three predictive factors for mortality: disease stage, histological grade and lymph node involvement.
authors.affiliation: Service de carcinologie médicale, CHU Habib-Bourguiba, 3029 Sfax, Tunisie.
authors.forename: J
authors.initials: J
authors.lastname: Feki
authors.affiliation: Service de carcinologie-radiothérapie, CHU Habib-Bourguiba, 3029 Sfax, Tunisie. Electronic address: nejla_fourati@yahoo.fr.
authors.forename: N
authors.initials: N
authors.lastname: Fourati
authors.affiliation: Laboratoire d'anatomie et de cytologie pathologiques, CHU Habib-Bourguiba, 3029 Sfax, Tunisie.
authors.forename: H
authors.initials: H
authors.lastname: Mnif
authors.affiliation: Laboratoire d'anatomie et de cytologie pathologiques, CHU Habib-Bourguiba, 3029 Sfax, Tunisie.
authors.forename: A
authors.initials: A
authors.lastname: Khabir
authors.affiliation: Service de carcinologie médicale, CHU Habib-Bourguiba, 3029 Sfax, Tunisie.
authors.forename: N
authors.initials: N
authors.lastname: Toumi
authors.affiliation: Service de carcinologie médicale, CHU Habib-Bourguiba, 3029 Sfax, Tunisie.
authors.forename: A
authors.initials: A
authors.lastname: Khanfir
authors.affiliation: Laboratoire d'anatomie et de cytologie pathologiques, CHU Habib-Bourguiba, 3029 Sfax, Tunisie.
authors.forename: T
authors.initials: T
authors.lastname: Boudawara
authors.affiliation: Service de gynécologie-obstétrique, CHU Hédi-Chaker, 3029 Sfax, Tunisie.
authors.forename: H
authors.initials: H
authors.lastname: Amouri
authors.affiliation: Service de carcinologie-radiothérapie, CHU Habib-Bourguiba, 3029 Sfax, Tunisie.
authors.forename: J
authors.initials: J
authors.lastname: Daoud
authors.affiliation: Service de carcinologie médicale, CHU Habib-Bourguiba, 3029 Sfax, Tunisie.
authors.forename: M
authors.initials: M
authors.lastname: Frikha
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D047072:Aromatase Inhibitors / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000378:metabolism; D001859:Bone Neoplasms / Q000556:secondary / Q000628:therapy; D001943:Breast Neoplasms / Q000378:metabolism / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D018278:Carcinoma, Neuroendocrine / Q000378:metabolism / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D017024:Chemotherapy, Adjuvant / Q000706:statistics & numerical data; D053379:Chromogranin A / Q000378:metabolism; D018572:Disease-Free Survival; D005260:Female; D006785:Hospitals, University; D006801:Humans; D008175:Lung Neoplasms / Q000556:secondary / Q000628:therapy; D008408:Mastectomy / Q000706:statistics & numerical data; D015412:Mastectomy, Segmental / Q000706:statistics & numerical data; D008875:Middle Aged; D018714:Radiotherapy, Adjuvant / Q000706:statistics & numerical data; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000378:metabolism; D011959:Receptors, Estradiol / Q000378:metabolism; D011980:Receptors, Progesterone / Q000378:metabolism; D012189:Retrospective Studies; D013629:Tamoxifen / Q000627:therapeutic use; D000068878:Trastuzumab; D014416:Tunisia / Q000453:epidemiology
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D018931:Antineoplastic Agents, Hormonal; D047072:Aromatase Inhibitors; D014408:Biomarkers, Tumor; D053379:Chromogranin A; D018719:Erb-b2 Receptor Tyrosine Kinases; D011959:Receptors, Estradiol; D011980:Receptors, Progesterone; D013629:Tamoxifen; D000068878:Trastuzumab; C508053:ERBB2 protein, human
keywords: Breast; Carcinome neuroendocrine; Immunohistochemistry; Immunohistochimie; Neuroendocrine carcinoma; Prognostic; Pronostic; Sein; Survie; Survival