Non-Metastatic Triple Negative Breast Cancer with Neuroendocrine Differentiation: Survival Parameters

Background: Atesting for neuroendocrine markers during breast cancer diagnosis is rarely required. Also, breast cancer with neuroendocrine differentiation is highly under presented in clinical trials. Objective: This research aimed to study patients with triple negative breast cancer (TNBC) with neuroendocrine differentiation to outline their characteristics and outcomes. Patients and methods: We examined effect of synaptophysin expression and other clinicopathological features of 35 non-metastatic triple negative breast cancer females for disease free survival (DFS) and overall survival (OS). Results: There was a statistically significant association between synaptophysin-enriched expression and tumor infiltrating lymphocytes (TILs) > 50% in TNBC patients (P= 0.047). Stage III disease, tumor size ≥ T3, high Ki67 and presence of ductal carcinoma in situ (DCIS) were significantly associated with decreased DFS. Tumor size ≥ T3 and high Ki67 were bad prognostic factors for overall survival. Of note, Ki67 was the sole independent prognostic factor predicting DFS and OS. Conclusion: There is a clear association between synaptophysin expression and increased TILs percentage in TNBC raising the possible benefit of immunotherapy in this category of breast cancer, however, further study with larger sample size is needed for outlining the survival effects of synaptophysin expression.