• Diana Maria Chiorean, Melinda-Ildiko Mitranovici, Maria Cezara Mureșan, Corneliu-Florin Buicu, Raluca Moraru, Liviu Moraru, Titiana Cornelia Cotoi, Ovidiu Simion Cotoi, Adrian Apostol, Sabin Gligore Turdean, Claudiu Mărginean, Ion Petre, Ioan Emilian Oală, Zsuzsanna Simon-Szabo, Viviana Ivan, Ancuța Noela Roșca, and Havva Serap Toru.
• Department of Pathology, County Clinical Hospital of Targu Mures, 540072 Targu Mures, Romania.
• Medicina (Kaunas). 2023 Mar 28; 59 (4).

AbstractPrimary neuroendocrine tumors (NETs) of the breast are considered a rare and undervalued subtype of breast carcinoma that occur mainly in postmenopausal women and are graded as G1 or G2 NETs or an invasive neuroendocrine carcinoma (NEC) (small cell or large cell). To establish a final diagnosis of breast carcinoma with neuroendocrine differentiation, it is essential to perform an immunohistochemical profile of the tumor, using antibodies against synaptophysin or chromogranin, as well as the MIB-1 proliferation index, one of the most controversial markers in breast pathology regarding its methodology in current clinical practice. A standardization error between institutions and pathologists regarding the evaluation of the MIB-1 proliferation index is present. Another challenge refers to the counting process of MIB-1's expressiveness, which is known as a time-consuming process. The involvement of AI (artificial intelligence) automated systems could be a solution for diagnosing early stages, as well. We present the case of a post-menopausal 79-year-old woman diagnosed with primary neuroendocrine carcinoma of the breast (NECB). The purpose of this paper is to expose the interpretation of MIB-1 expression in our patient' s case of breast neuroendocrine carcinoma, assisted by artificial intelligence (AI) software (HALO-IndicaLabs), and to analyze the associations between MIB-1 and common histopathological parameters.

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