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Perineural Invasion in Breast Cancer: A Comprehensive Review
Hisham F Bahmad1, Carter Wegner2, Joana Nuraj2
1Department of Pathology and Laboratory Medicine, University of Miami Miller School of Medicine, Miami, FL 33136, USA.
Cancers
|June 26, 2025
Summary
Perineural invasion (PNI) in breast cancer, common in aggressive subtypes, involves tumor-nerve interactions. Its prognostic significance requires further study, highlighting the need for refined diagnostics and targeted therapies.
Area of Science:
- Oncology
- Pathology
- Molecular Biology
Background:
- Perineural invasion (PNI) is a known feature in various cancers, but its role in breast cancer is not well understood.
- PNI is frequently identified in high-grade invasive ductal carcinoma (IDC), especially triple-negative and HER2-positive subtypes, and certain special histological types.
Purpose of the Study:
- To review current knowledge on perineural invasion (PNI) in breast cancer.
- To discuss PNI's histopathologic features, molecular mechanisms, diagnostic challenges, and clinical relevance.
Main Methods:
- Literature review synthesizing existing research on PNI in breast cancer.
- Analysis of histopathologic features, molecular pathways, and clinical outcomes associated with PNI.
Main Results:
- PNI is associated with aggressive breast cancer subtypes and involves complex tumor-neural interactions.
- Mechanisms include neurotrophic signaling and epithelial-mesenchymal transition, potentially driving tumor progression and recurrence.
Conclusions:
- The independent prognostic value of PNI in breast cancer is unclear due to limited large-scale studies.
- Further research is crucial to clarify PNI's significance, improve diagnostic accuracy, and explore therapeutic strategies.
