title: Neuroendocrine Carcinoma of the Breast: Current Evidence and Future Perspectives.
abstract: : Neuroendocrine carcinoma of the breast is considered a rare entity, and for this reason there are no data from prospective clinical trials on its optimal management. Early stage tumors are usually treated with the same strategy used for the other types of invasive breast cancer. Anthracycline- and taxane-based regimens represent the most frequently administered chemotherapy in neoadjuvant and adjuvant setting, as well as for metastatic disease, although combinations of platinum compounds and etoposide have been widely used, in particular for small-cell histology and tumors with a high proliferation index. For metastatic disease, a multimodality therapeutic strategy can be considered on an individual basis, with chemotherapy, endocrine therapy, peptide receptor radionuclide therapy, radiation therapy, surgery, or a combination of the above. In the near future, a better knowledge of the biology of these tumors will hopefully provide new therapeutic targets for personalized treatment. In this review, we discuss the current evidence and the future perspectives on diagnosis and treatment of neuroendocrine carcinoma of the breast.
  
  
  CONCLUSIONS
  Neuroendocrine carcinoma of the breast (NECB) is a distinct entity of breast cancer. Clinical features and morphology are not helpful to distinguish NECB from other subtypes of breast cancer; therefore, immunohistochemistry markers for neuroendocrine differentiation, mainly chromogranin and synaptophysin, should be routinely used to confirm the diagnosis, especially in cases of mucinous or solid papillary carcinoma in which the suspicion of NECB may be relevant. Adjuvant treatment should be offered according to the same recommendations given for the other types of invasive breast cancer. An accurate diagnosis of NECB is also important in the metastatic setting, in which a multimodality approach including specific therapies such as peptide receptor radionuclide therapy can be considered.
authors.affiliation: Department of Medical Oncology, Ospedale Sacro Cuore Don Calabria, Negrar, Verona, Italy alessandro.inno@sacrocuore.it.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Inno
authors.affiliation: Department of Pathology, Ospedale Sacro Cuore Don Calabria, Negrar, Verona, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Bogina
authors.affiliation: Department of Medical Oncology, Ospedale Sacro Cuore Don Calabria, Negrar, Verona, Italy.
authors.forename: Monica
authors.initials: M
authors.lastname: Turazza
authors.affiliation: Department of Pathology, Ospedale Sacro Cuore Don Calabria, Negrar, Verona, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Bortesi
authors.affiliation: Department of Medical Oncology, Ospedale Sacro Cuore Don Calabria, Negrar, Verona, Italy.
authors.forename: Simona
authors.initials: S
authors.lastname: Duranti
authors.affiliation: Department of Surgery, Ospedale Sacro Cuore Don Calabria, Negrar, Verona, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Massocco
authors.affiliation: Department of Pathology, Ospedale Sacro Cuore Don Calabria, Negrar, Verona, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Zamboni
authors.affiliation: Department of Radiology, Ospedale Sacro Cuore Don Calabria, Negrar, Verona, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Carbognin
authors.affiliation: Department of Radiotherapy, Ospedale Sacro Cuore Don Calabria, Negrar, Verona, Italy.
authors.forename: Filippo
authors.initials: F
authors.lastname: Alongi
authors.affiliation: Department of Nuclear Medicine, Ospedale Sacro Cuore Don Calabria, Negrar, Verona, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Salgarello
authors.affiliation: Department of Medical Oncology, Ospedale Sacro Cuore Don Calabria, Negrar, Verona, Italy.
authors.forename: Stefania
authors.initials: S
authors.lastname: Gori
mesh_terms: D001943:Breast Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000628:therapy*; D018278:Carcinoma, Neuroendocrine / Q000175:diagnosis / Q000473:pathology / Q000556:secondary / Q000628:therapy*; D002454:Cell Differentiation; D005260:Female; D006801:Humans; D020360:Neoadjuvant Therapy; D009362:Neoplasm Metastasis; D057285:Precision Medicine; D011379:Prognosis
keywords: Carcinoid tumors; Diagnosis; Neuroendocrine breast carcinoma; Neuroendocrine differentiation; Small-cell breast cancer; Treatment