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Neuroendocrine ductal carcinoma in situ (NE‐DCIS) of the breast – comparative clinicopathological study of 20 NE‐DCIS cases and 274 non‐NE‐DCIS cases
Author(s) -
Kawasaki T,
Nakamura S,
Sakamoto G,
Murata S,
Tsunodashimizu H,
Suzuki K,
Takahashi O,
Nakazawa T,
Kondo T,
Katoh R
Publication year - 2008
Publication title -
histopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.626
H-Index - 124
eISSN - 1365-2559
pISSN - 0309-0167
DOI - 10.1111/j.1365-2559.2008.03093.x
Subject(s) - ductal carcinoma , chromogranin a , medicine , pathology , synaptophysin , breast cancer , carcinoma in situ , nipple discharge , carcinoma , immunohistochemistry , cancer , mammography
Aims: To clarify the clinicopathological significance of breast neuroendocrine ductal carcinoma in situ (NE‐DCIS), i.e. DCIS in which >50% of cells immunohistochemically express NE markers (chromogranin A and/or synaptophysin), 20 NE‐DCIS were studied and the findings compared with those of 274 non‐NE‐DCIS. Methods and results: NE‐DCIS accounted for 6.8% of all DCIS. Mean patient age was 50.4 years for NE‐DCIS and 49.6 years for non‐NE‐DCIS ( P = 0.66). The main clinical presentation of NE‐DCIS was a bloody nipple discharge, seen in 72%, significantly different from the 5% in non‐NE‐DCIS cases ( P < 0.01). Carcinoma was preoperatively diagnosed in 67% of NE‐DCIS and 95% of non‐NE‐DCIS cases ( P < 0.01). NE‐DCIS was histologically characterized by a predominantly solid growth of cancer cells with fine‐granular cytoplasm and ovoid, or occasionally spindle‐shaped nuclei. A well‐developed vascular network was also common. Nuclear grades and Van Nuys classification were significantly lower for NE‐DCIS than for non‐NE‐DCIS ( P < 0.01). The mean MIB‐1 labelling index was 4.3% in NE‐DCIS and 8.1% in non‐NE‐DCIS ( P < 0.01). Furthermore, NE‐DCIS cases had significantly higher oestrogen and progesterone receptor and lower HER2 scores than non‐NE‐DCIS cases ( P < 0.01). Conclusions: NE‐DCIS has characteristic clinicopathological features and can, therefore, be regarded as a distinct variant of DCIS.