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Published on: August 1, 2018
Radiological and Histopathological Predictors of Survival in Neuroendocrine Differentiated Breast Cancer: A
Hülya Çetin Tunçez1, Zehra Hilal Adibelli1,2, Nebil Havvat3
1Department of Radiology, Izmir City Hospital, Izmir, 35540, Turkey.
Purpose:
This study aims to compare the radiological and immunohistochemical (IHC) features of neuroendocrine differentiated breast cancer (NEBC) with those of non-specific invasive ductal carcinoma (NS-IDC) and to examine the prognostic relevance of these features, including their association with overall survival (OS).
Patients And Methods:
Patients with histopathologically confirmed NEBC between 2015 and 2022 were retrospectively identified. Inclusion criteria were availability of preoperative mammography, ultrasonography, and magnetic resonance imaging (MRI), along with complete clinical records; patients with missing data were excluded. A randomly selected NS-IDC cohort from the same institutional database served as the comparison group. Histopathology was the reference standard. Imaging was reassessed by two breast radiologists, and pathological specimens were reviewed by an experienced breast pathologist. Statistical analyses were performed using IBM SPSS 26.0, with significance set at p < 0.05.
Results:
Eighty-five patients (44 NEBC, 41 NS-IDC) were included. Compared with NS-IDC, NEBC more frequently demonstrated rapid initial enhancement and late washout on MRI (p=0.001 and p=0.009, respectively), and higher progesterone reseptor (PR) expression (p=0.037). Five-year OS did not differ significantly between groups (p = 0.858). Multivariate analysis revealed that the presence of ductal carcinoma in situ (DCIS), T stage, and T2 hyperintensity on MRI emerged as independent predictors of mortality (p = 0.006, p = 0.003, and p = 0.028, respectively).
Conclusion:
Although NEBC exhibits distinct MRI characteristics and a predominantly hormone-positive IHC profile, survival outcomes were comparable to those of NS-IDC. Notably, T2 hyperintensity on MRI was the strongest imaging feature associated with poorer survival, suggesting a potential role in future prognostic stratification. The modest sample size, prognostic interpretations should be viewed as exploratory. Larger prospective studies are needed to validate these findings.
