- Email: [email protected]
226. Primary neuroendocrine carcinoma of the breast: A rare entity
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ABSTRACTS
Table Assessed parameters Clinical aspects
Immune status* Pathology
Immunohistochemistry
Age
Lymphocytes blastic transformation (BLT) Serum IgG, IgA, IgM
Sentinel lymph nodes status
Estrogenic and progesterone receptors (ER and PR)
Tumour size and Histopathological grade (G) Peritumoural tissue invasion Lymphocytic peritumoural infiltrate
Her2 oncogene
Hormonal status
Tumour IL-2 diameter
Ki-67 proliferation markers bcl-2 protein
Conflict of interest: No conflict of interest. http://dx.doi.org/10.1016/j.ejso.2016.06.157
226. Primary neuroendocrine carcinoma of the breast: A rare entity D. Dahiya PGIMER- Chandigarh, Department of Surgery, Chandigarh, India Background: Primary neuroendocrine carcinoma (NEC) of the breast is a rare entity and accounts for less than 5% of all breast cancers. It was first recognised and reported in the literature in 1963. World health organisation (WHO) defined mammary NEC in 2003 as having >50% neoplastic cells expressing neuroendocrine markers in the tumor tissue. Biological behaviour and treatment of this entity has not been studied in detail unlike infiltrating duct carcinoma or other rare tumors of the breast (tubular, mucinous or medullary carcinoma). In the absence of any large series the optimal treatment is uncertain. Herein we retrospectively analysed NEC of breast who were treated at our centre. Material and methods: We retrospectively analysed cases of NEC of breast who received treatment between January 2012 and December 2015 in the Department of Surgery (unit III) at Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh. Patients were diagnosed to have NEC of breast if pathological examination of tumor revealed the presence of >50% of invasive tumor cells with cytoplasmic immunoreactivity for synaptophysin, chromogranin, or CD56. Results: We operated 170 cases of carcinoma breast between January 2012 and December 2015 in the Department of Surgery (unit III) PGIMER, Chandigarh. In two patients (1.17%) final histopathology came as NEC of breast based on WHO criteria having >50% neoplastic cells expressing neuroendocrine markers in the tumor tissue. Age of these females was 35 and 61 years. There was no definite PET evidence of abnormal somatostatin receptor expressing lesion anywhere in the body; which was performed postoperatively after obtaining the final histopathology report. They received adjuvant chemotherapy, radiotherapy and hormone therapy. Both these patients are doing well on 18 months post surgery with no evidence of local or systemic recurrence. Conclusion: NEC of the breast is a pathological entity. Surgery with adjuvant treatment for NEC of breast appears as a viable treatment option. Conflict of interest: No conflict of interest. http://dx.doi.org/10.1016/j.ejso.2016.06.158
227. Retrospective clinicopathological follow-up of very young women (under 35 years old) with breast cancer in Hungary A. Szollar, A. Savolt, Z. Matrai National Institute of Oncology, Department of Breast and Sarcoma Surgery, Budapest, Hungary
Aims: A dramatic increase in the number of breast cancers diagnosed in premenopausal women has been reported, suggest a number scientific, oncologic and clinico-social question to discuss. Patients and methods: In the National Institute of Oncology between 2000.01.01. and 2015.01.01, we performed diagnosed under 35 years and multidisciplinary treated, through followed-up oncologically a number of 300 very young patients with breast cancer retrospective following, took the data base of the Department of Breast and Sarcoma Surgery basis. From the same data base and same period we set a number of multidisciplinary treated, through followed-up oncologically 300 patients aged between 35 and 40 against this group of very young patients. The average age of the very young patients was 33 years (range 14e35), the interval time was 36 months (range 12e174). The parameters of the clinical processing patients: individual and familial anamnesis, the menstrual term, the number or pregnancy and childbearing, the interval of the lactation, contraception, diagnostical screening procedures, fine-needle aspiration cytology and core biopsy, TNM, neoadjuvant therapy, pathological parameters, , the number and types of the operations, adjuvant and locoregional treatments, reconstructive surgery, overall and disease free survival. Results: We found significant difference about the overall and disease free survival between these two groups, put the very young patients at a disadvantage. We would like to review the results of the clinicopathological investigation and the statistical analysis about these patients. Conflict of interest: No conflict of interest. http://dx.doi.org/10.1016/j.ejso.2016.06.159
228. Phase II study on radiofrequency ablation in early breast cancer S. Imoto, T. Ueno, H. Isaka, H. Ito, K. Miyamoto, M. Kitamura Kyorin University Hospital, Department of Breast Surgery, Mitaka, Japan Background: Recent advances of screening mammography and primary chemotherapy make it possible to identify small size of breast cancer (BC) and minimize surgical management. Previously we reported the result of radiofrequency ablation (RFA) immediately followed by breast-conserving surgery (BCS) in 30 patients with T1N0 BC (Breast, 18:130-4, 2009). Complete ablation was found in 26 patients (87%) from the pathological diagnosis of tumor specimens stained with hematoxylineeosin and nicotinamide adenine dinucleotide diaphorase. Thus, we conducted a phase II study to evaluate the safety and reliability of RFA alone in BC (UMIN000020805). Material and methods: T1 and sentinel node-negative BC patients were eligible. BC with diffuse calcification or extensive intraductal component (EIC) was excluded. RFA was performed using a LeVeen needle electrode system (Boston Scientific Corporation, USA). Primary endpoint was breast deformity due to RFA, which was calculated from ratios of the length from nipple to several points measured in affected breast and unaffected breast before and after RFA. Secondary endpoints were adverse events, ipsilateral breast tumor recurrence (IBTR) and QOL assessment of FACT-B. Results: Although 29 patients were required for statistical significance, 20 patients agreed to undergo RFA between May in 2009 and February in 2013. Their mean age was 63 years old. It took from 4 to 24 min for ablation time. No severe adverse events were observed except pain control with NSAID administration. Most patients received breast irradiation and hormonal therapy. Breast deformity had been small between pretreatment and 12 months after RFA (n ¼ 12). Total outcome index, FACT-G and FACT-B total index had been not changed at the time of pretreatment, 6 months and 12 months after RFA (n ¼ 16). The median follow-up was 63 months. One patient had contralateral non-invasive BC, but IBTR and distant organ metastasis had not been observed in all patients. Conclusion: RFA is a promising alternative to BCS in stage I BC without EIC. Conflict of interest: No conflict of interest. http://dx.doi.org/10.1016/j.ejso.2016.06.160
ABSTRACTS
Table Assessed parameters Clinical aspects
Immune status* Pathology
Immunohistochemistry
Age
Lymphocytes blastic transformation (BLT) Serum IgG, IgA, IgM
Sentinel lymph nodes status
Estrogenic and progesterone receptors (ER and PR)
Tumour size and Histopathological grade (G) Peritumoural tissue invasion Lymphocytic peritumoural infiltrate
Her2 oncogene
Hormonal status
Tumour IL-2 diameter
Ki-67 proliferation markers bcl-2 protein
Conflict of interest: No conflict of interest. http://dx.doi.org/10.1016/j.ejso.2016.06.157
226. Primary neuroendocrine carcinoma of the breast: A rare entity D. Dahiya PGIMER- Chandigarh, Department of Surgery, Chandigarh, India Background: Primary neuroendocrine carcinoma (NEC) of the breast is a rare entity and accounts for less than 5% of all breast cancers. It was first recognised and reported in the literature in 1963. World health organisation (WHO) defined mammary NEC in 2003 as having >50% neoplastic cells expressing neuroendocrine markers in the tumor tissue. Biological behaviour and treatment of this entity has not been studied in detail unlike infiltrating duct carcinoma or other rare tumors of the breast (tubular, mucinous or medullary carcinoma). In the absence of any large series the optimal treatment is uncertain. Herein we retrospectively analysed NEC of breast who were treated at our centre. Material and methods: We retrospectively analysed cases of NEC of breast who received treatment between January 2012 and December 2015 in the Department of Surgery (unit III) at Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh. Patients were diagnosed to have NEC of breast if pathological examination of tumor revealed the presence of >50% of invasive tumor cells with cytoplasmic immunoreactivity for synaptophysin, chromogranin, or CD56. Results: We operated 170 cases of carcinoma breast between January 2012 and December 2015 in the Department of Surgery (unit III) PGIMER, Chandigarh. In two patients (1.17%) final histopathology came as NEC of breast based on WHO criteria having >50% neoplastic cells expressing neuroendocrine markers in the tumor tissue. Age of these females was 35 and 61 years. There was no definite PET evidence of abnormal somatostatin receptor expressing lesion anywhere in the body; which was performed postoperatively after obtaining the final histopathology report. They received adjuvant chemotherapy, radiotherapy and hormone therapy. Both these patients are doing well on 18 months post surgery with no evidence of local or systemic recurrence. Conclusion: NEC of the breast is a pathological entity. Surgery with adjuvant treatment for NEC of breast appears as a viable treatment option. Conflict of interest: No conflict of interest. http://dx.doi.org/10.1016/j.ejso.2016.06.158
227. Retrospective clinicopathological follow-up of very young women (under 35 years old) with breast cancer in Hungary A. Szollar, A. Savolt, Z. Matrai National Institute of Oncology, Department of Breast and Sarcoma Surgery, Budapest, Hungary
Aims: A dramatic increase in the number of breast cancers diagnosed in premenopausal women has been reported, suggest a number scientific, oncologic and clinico-social question to discuss. Patients and methods: In the National Institute of Oncology between 2000.01.01. and 2015.01.01, we performed diagnosed under 35 years and multidisciplinary treated, through followed-up oncologically a number of 300 very young patients with breast cancer retrospective following, took the data base of the Department of Breast and Sarcoma Surgery basis. From the same data base and same period we set a number of multidisciplinary treated, through followed-up oncologically 300 patients aged between 35 and 40 against this group of very young patients. The average age of the very young patients was 33 years (range 14e35), the interval time was 36 months (range 12e174). The parameters of the clinical processing patients: individual and familial anamnesis, the menstrual term, the number or pregnancy and childbearing, the interval of the lactation, contraception, diagnostical screening procedures, fine-needle aspiration cytology and core biopsy, TNM, neoadjuvant therapy, pathological parameters, , the number and types of the operations, adjuvant and locoregional treatments, reconstructive surgery, overall and disease free survival. Results: We found significant difference about the overall and disease free survival between these two groups, put the very young patients at a disadvantage. We would like to review the results of the clinicopathological investigation and the statistical analysis about these patients. Conflict of interest: No conflict of interest. http://dx.doi.org/10.1016/j.ejso.2016.06.159
228. Phase II study on radiofrequency ablation in early breast cancer S. Imoto, T. Ueno, H. Isaka, H. Ito, K. Miyamoto, M. Kitamura Kyorin University Hospital, Department of Breast Surgery, Mitaka, Japan Background: Recent advances of screening mammography and primary chemotherapy make it possible to identify small size of breast cancer (BC) and minimize surgical management. Previously we reported the result of radiofrequency ablation (RFA) immediately followed by breast-conserving surgery (BCS) in 30 patients with T1N0 BC (Breast, 18:130-4, 2009). Complete ablation was found in 26 patients (87%) from the pathological diagnosis of tumor specimens stained with hematoxylineeosin and nicotinamide adenine dinucleotide diaphorase. Thus, we conducted a phase II study to evaluate the safety and reliability of RFA alone in BC (UMIN000020805). Material and methods: T1 and sentinel node-negative BC patients were eligible. BC with diffuse calcification or extensive intraductal component (EIC) was excluded. RFA was performed using a LeVeen needle electrode system (Boston Scientific Corporation, USA). Primary endpoint was breast deformity due to RFA, which was calculated from ratios of the length from nipple to several points measured in affected breast and unaffected breast before and after RFA. Secondary endpoints were adverse events, ipsilateral breast tumor recurrence (IBTR) and QOL assessment of FACT-B. Results: Although 29 patients were required for statistical significance, 20 patients agreed to undergo RFA between May in 2009 and February in 2013. Their mean age was 63 years old. It took from 4 to 24 min for ablation time. No severe adverse events were observed except pain control with NSAID administration. Most patients received breast irradiation and hormonal therapy. Breast deformity had been small between pretreatment and 12 months after RFA (n ¼ 12). Total outcome index, FACT-G and FACT-B total index had been not changed at the time of pretreatment, 6 months and 12 months after RFA (n ¼ 16). The median follow-up was 63 months. One patient had contralateral non-invasive BC, but IBTR and distant organ metastasis had not been observed in all patients. Conclusion: RFA is a promising alternative to BCS in stage I BC without EIC. Conflict of interest: No conflict of interest. http://dx.doi.org/10.1016/j.ejso.2016.06.160