Factors predicting treatment responsiveness and prognosis in node-negative breast cancer. The International (Ludwig) Breast Cancer Study Group.

Neville, A. Munro; Bettelheim, R.; Gelber, Richard D.; Säve-Söderbergh, J; Davis, Ben; Reed, Richard C.; Torhorst, J.; Golouh, Rastko; Peterson, Harriet F.; Price, Karen N.

doi:10.1200/jco.1992.10.5.696

Cited by 106 publications

(43 citation statements)

References 29 publications

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“…Earlier analyses of the entire IBCSG Trial V data set of 1275 LN negative patients at 5 years of median follow-up were able to detect significant improvements in DFS for patients who received the PeCT regimen, especially among those with BRG 2 and 3 tumors. 3 The difference in conclusions between the earlier publication and our analysis appears to be due to the inclusion of late term effects of PeCT. In particular, those patients with rapidly proliferating or Grade 3 tumors, for whom special benefit from chemotherapy has been suggested, did not demonstrate a significantly improved DFS or OS with a single cycle of combination treatment at a median of 12 years of follow-up.…”

Section: Discussioncontrasting

confidence: 53%

“…The trial and the clinical results have been described in detail elsewhere. 3,9,10 In this study, the two treatment arms that received prolonged chemotherapy (conventionally timed with or without perioperative chemotherapy) were combined because the prognoses for these two groups were similar.…”

Section: Trial Designmentioning

confidence: 99%

“…Although it has been reported that the grade of breast carcinoma can be used to predict the rate of tumor shrinkage with treatment, 1 this question has predominantly been addressed in studies of groups of women with specific disease parameters and often in studies of patients receiving disparate chemotherapeutic regimens. The role of grade in predicting the responses of lymph node (LN) positive 2 and LN negative 3 breast carcinoma patients has been examined in few series. In this study, we have examined the role of histologic grade in predicting outcome in a large, multicenter series of well-characterized patients with both LN negative and LN positive disease who had received specific therapeutic regimens and for whom long term follow-up data were available.…”

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confidence: 99%

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The importance of the histologic grade of invasive breast carcinoma and response to chemotherapy

Pinder

Murray

Ellis

et al. 1998

Cancer

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Section: Discussioncontrasting

confidence: 53%

Section: Trial Designmentioning

confidence: 99%

mentioning

confidence: 99%

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The importance of the histologic grade of invasive breast carcinoma and response to chemotherapy

Pinder

Murray

Ellis

et al. 1998

Cancer

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“…Therefore, tumour cell emboli in lymph and blood vessels are considered to be the morphological correlates of BC metastasising to loco-regional lymph nodes (LNs) and distant haematogenous sites, respectively. The presence of lymphovascular invasion indeed has been correlated to the presence of LN metastases and to poor prognosis in patients with BC (Sampat et al, 1977;Nealon et al, 1979Nealon et al, , 1981Dawson et al, 1982Dawson et al, , 1986Weigand et al, 1982;Bettelheim et al, 1984;Berger et al, 1988;Rosen et al, 1989Rosen et al, , 1991Lee et al, 1990;Clayton, 1991;Clemente et al, 1992;Neville et al, 1992;Fisher et al, 1993a, b;Lauria et al, 1995). Recently, interest in (lympho)vascular invasion has been increased owing to addition of peritumoural (lympho)vascular invasion to the St Gallen criteria for selection of adjuvant systemic treatment in operable BC (Goldhirsch et al, 2005).…”

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confidence: 99%

Distinguishing blood and lymph vessel invasion in breast cancer: a prospective immunohistochemical study

et al. 2006

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Recently, peritumoural (lympho)vascular invasion, assessed on haematoxylin -eosin (HE)-stained slides, was added to the St Gallen criteria for adjuvant treatment of patients with operable breast cancer (BC). New lymphatic endothelium-specific markers, such as D2-40, make it possible to distinguish between blood (BVI) and lymph vessel invasion (LVI). The aim of this prospective study was to quantify and compare BVI and LVI in a consecutive series of patients with BC. Three consecutive sections of all formalin-fixed paraffinembedded tissue blocks of 95 BC resection specimens were (immuno)histochemically stained in a fixed order: HE, anti-CD34 (panendothelium) and anti-D2-40 (lymphatic endothelium) antibodies. All vessels with vascular invasion were marked and relocated on the corresponding slides. Vascular invasion was assigned LVI (CD34" or~/D2-40") or BVI (CD34"/D2-40~) and intra-(contact with tumour cells or desmoplastic stroma) or peritumoural. The number of vessels with LVI and BVI as well as the number of tumour cells per embolus were counted. Results were correlated with clinico-pathological variables. Sixty-six (69.5%) and 36 (37.9%) patients had, respectively, LVI and BVI. The presence of 'vascular' invasion was missed on HE in 20% (peritumourally) and 65% (intratumourally) of cases. Although LVI and BVI were associated intratumourally (P ¼ 0.02), only peritumoural LVI, and not BVI, was associated with the presence of lymph node (LN) metastases (p peri ¼ 0.002). In multivariate analysis, peritumoural LVI was the only independent determinant of LN metastases. Furthermore, the number of vessels with LVI was larger than the number of vessels with BVI (P ¼ 0.001) and lymphatic emboli were larger than blood vessel emboli (P ¼ 0.004). We demonstrate that it is possible to distinguish between BVI and LVI in BC specimens using specific lymphatic endothelium markers. This is important to study the contribution of both processes to BC metastasis. Furthermore, immunohistochemical detection of lymphovascular invasion might be of value in clinical practice.

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“…Although few studies have reported controversial roles for lymphovascular invasion as a prognostic factor (3, 14, 21), a great number of studies have confirmed the important role lymphovascular invasion plays in survival prognosis of breast cancer patients (Neville et al, 1992;Lauria et al, 1995;Camp et al, 2000;Voogd, 2001;Woo et al, 2002;Kuru et al, 2003;Sebastian et al, 2004;Pauline et al, 2005;Ashwini et al, 2008). The results of the present study are in line with those of the most recent studies and show the important role lymphovascular invasion plays as an independent prognostic risk factor in both lymph node negative and positive patients.…”

Section: Discussionmentioning

confidence: 98%

Vascular Invasion as an Independent Prognostic Factor in Lymph Node Negative Invasive Breast Cancer

Rezaianzadeh¹,

Talei²,

Rajaeefard³

et al. 2012

Asian Pacific Journal of Cancer Prevention

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Introduction: Identification of simple and measurable prognostic factors is an important issue in treatment evaluation of breast cancer. The present study was conducted to evaluate the prognostic role of vascular invasion in lymph node negative breast cancer patients. Methods: in a retrospective design, we analyzed the recorded profiles of the 1,640 patients treated in the breast cancer department of Motahari clinic affiliated to Shiraz University of Medical Sciences, Shiraz, Iran, from January 1999 to December 2012. Overall and adjusted survivals were evaluated by the Cox proportional hazard model. All the hypotheses were considered two-sided and a p-value of 0.05 or less was considered as statistically significant. Results: Mean age in lymph node negative and positive patients was 50.0 and 49.8 respectively. In lymph node negative patients, the number of nodes, tumor size, lymphatic invasion, vascular invasion, progesterone receptor, and nuclear grade were significant predictors. In lymph node and lymphatic negative patients, vascular invasion also played a significant prognostic role in the survival which was not evident in lymph node negative patients with lymphatic invasion. Discussion: The results of our large cohort study, with long term follow up and using multivariate Cox proportional model and comparative design showed a significant prognostic role of vascular invasion in early breast cancer patients. Vascular invasion as an independent prognostic factor in lymph node negative invasive breast cancer

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Factors predicting treatment responsiveness and prognosis in node-negative breast cancer. The International (Ludwig) Breast Cancer Study Group.

Abstract: Hormone receptor status and tumor grade are important factors for predicting responsiveness to perioperative chemotherapy in node-negative breast cancer.

Cited by 106 publications

References 29 publications

The importance of the histologic grade of invasive breast carcinoma and response to chemotherapy

The importance of the histologic grade of invasive breast carcinoma and response to chemotherapy

Distinguishing blood and lymph vessel invasion in breast cancer: a prospective immunohistochemical study

Vascular Invasion as an Independent Prognostic Factor in Lymph Node Negative Invasive Breast Cancer

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