MEMENİN NÖROENDOKRİN KARSİNOMU: 18 HASTA VE UZUN DÖNEM SONUÇLARI

Öz

Amaç: Nöroendokrin meme karsinomu (NMK) nadir görülen ve özellikli bir meme tümörüdür. Bu alt tipin tedavisi ve prognozu ile ilgili bilgiler sınırlıdır. Çalışmamızda, bu nadir görülen tümörün klinikopatolojik özelliklerini, tedavisini ve klinik sonuçlarını inceledik. Gereç ve Yöntemler: Temmuz 2008 ve Ocak 2018 tarihleri arasında NMK tanısı alan hastaların verileri retrospektif olarak incelendi. Bulgular: Toplam kayıtlı 4896 meme kanseri hastasının 18’i NMK idi (toplam vakaların %0,4’ü). Ortanca yaş 61,5 (30-82) olarak bulundu. On üç hastaya (%72,2) meme koruyucu cerrahi uygulandı. Sekiz hastaya ise aksiller lenf nodu diseksiyonu yapıldı. Sadece bir hasta patolojik evre 3 iken tüm hastalar patolojik olarak T1 ve T2 idi. Ortanca tümör boyutu 20,5 mm (10-45) olarak bulundu. Sadece iki hasta küçük hücreli alt tipi iken 16 hasta iyi-diferansiye alt tipindeydi. Tüm hastalar hormon reseptör pozitif ve HER2/ neu negatifti. Ki-67 değeri bilinen 15 hastadan 3 tanesinde yüksek Ki-67 değeri (>%20) mevcuttu. Ortanca 101 (33-148) aylık takip süresinde lokal-bölgesel veya uzak rekürrens görülmedi. On sekiz hastada hastalığa bağlı ölüm görülmedi. Sonuç: NMK genellikle hormon reseptör pozitif ve HER2/neu negatif olacak şekilde luminal A veya B olarak tespit edilmektedir. Aksilla pozitif hastalar olsa da özellikle iyi-diferansiye alt grupta sağ kalımlar çok iyidir. Bu hastalarda daha az girişimsel tedavi seçenekleri göz önünde bulundurulmalıdır.

Anahtar Kelimeler

• Nöroendokrinkarsinom
• meme neoplazmı
• prognoz

NEUROENDOCRINE CARCINOMA OF THE BREAST: 18 CASES WITH LONG-TERM FOLLOW-UP

Öz

Objective: Primary neuroendocrine carcinoma of the breast (NECB) is a rare distinct type of breast carcinoma. There is limited data about the optimal management, treatment, and prognosis. Therefore, we analyzed the clinicopathological features, management and the clinical outcome of this rare breast carcinoma. Material and Methods: Patients diagnosed as NECB between July 2008 and January 2018 were included in the study. Medical records were retrospectively reviewed. Results: A total of 4,896 breast cancer patients were reviewed and 18 NECB (0.4% of all cases) were extracted. The median age was 61.5 (30-82). Thirteen cases (72.2%) underwent breast conserving surgery. Eight patients had axillary lymph dissection. All of the cases were pathological T1 and T2. Only one patient was pathological stage 3. Median tumor size was 20.5mm (10- 45). Only two cases presented with small cell subtype, the rest were well-differentiated. Hormone receptor was positive and HER2/neu was negative for all cases. Of the 15 patients with known Ki-67, three had high expressions (≥20%). No local or distant disease recurrences and death related with NECB were detected at a median follow-up period of 101 months (33-148). Conclusion: NECB is more likely to be hormone receptor positive and HER2/neu negative as luminal A or B subtype. An excellent clinical outcome is remarkable despite a substantial number of patients with axillary lymph node positivity specifically for well-differentiated subtype. Less invasive treatment options should be kept in mind.

Anahtar Kelimeler

• Neuroendocrine carcinoma
• breast neoplasm
• prognosis

Kaynakça

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