Definitions and classifications of primary neuroendocrine (NE) carcinomas of the breast were first proposed by the World Health Organization (WHO) in 2003. Here we present a case of large-cell neuroendocrine carcinoma of the breast with regional nodal metastasis, which was diagnosed using cell morphology and immunohistochemical staining. We also reviewed 32 reported cases of primary breast NE carcinoma to identify prognostic factors associated with classes of this type of breast carcinoma defined according to the most recent WHO classification system. To our knowledge, this is the first study of breast carcinoma prognosis using the new WHO classification system.