Prognostic significance of tumor emboli in intramammary lymphatics in patients with mammary carcinoma

Nime, Freda; Rosen, Paul Peter; Thaler, Howard T.; Ashikari, Roy; Urban, Jerome A.

doi:10.1097/00000478-197701010-00003

Cited by 105 publications

(32 citation statements)

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“…LVI and BVI were found in 69.5 and 37.9% of patients, respectively. Other authors report LVI and especially BVI in BC to be less frequent: prevalences of LVI and BVI range from 8.8 (Nime et al, 1977) to 86% (Kahn and Marks, 2002) and from 4.2 (Lauria et al, 1995) to 33% (Kato et al, 2002), respectively. The presence and extent of LVI and BVI correlated with the size of the tumour and only the extent of LVI correlated with the number of blocks investigated.…”

Section: Discussionmentioning

confidence: 95%

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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Section: Discussionmentioning

confidence: 95%

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

et al. 2006

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“…This matter has so far received only scant attention (Bettelheim et al, 1983;Bettelheim & Neville, 1981;Kister et al, 1966;Nime et al, 1977;Roberts & Hahnel, 1981;Rosen et al, 1981Rosen et al, , 1982. Routine H & E histological preparations are quite adequate for the detection of vascular invasion by malignant cells provided a generous stromal edge to the tumour is taken (Bettelheim, et al, 1983).…”

Section: Discussionmentioning

confidence: 99%

Prognostic significance of peritumoral vascular invasion in breast cancer

Bettelheim¹,

Penman²,

Thornton‐Jones³

et al. 1984

Br J Cancer

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Summary A prospective study of 232 patients with primary invasive breast cancer (UICC Stages I, II and III) and histologically confirmed axillary node status was carried out to assess the prognostic significance of several readily available clinical and pathological characteristics. In addition to the recognised utility of tumour size and axillary lymph node status, the presence or absence of cohesive clumps of malignant cells in peritumoral vascular spaces (both lymphatic and blood vessels) was found to be prognostically important.The overall survival rate in breast cancer has not

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“…10,234 Specimen radiography was introduced for locating mammographically detected calcifications and occult carcinomas. 235 Microscopic studies extended to report, for example, lymphovascular invasion and tumor emboli, 236 extracapsular spread of metastatic carcinoma, 237 and microvessel density of tumors. 238 Other remarkable observations included the following: The role of programmed cell death (apoptosis), mainly caused by hypoxia and the fusion of chromosomal telomeres, 187,239 was identified as a barrier to the progression of cancer; it was observed that rapidly growing cancers contained low numbers of apoptotic cells because of the loss of proapoptotic regulators, including, among other things, the p53 tumor-suppressor gene.…”

Section: Surgical Pathology and Cytopathologymentioning

confidence: 99%

A note from history: Landmarks in history of cancer, part 7

Hajdu

Vadmal

Tang

2015

Cancer

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In the 2 and half decades reviewed , research established that chromosomal translocation, deletion, and DNA amplification are prerequisites to cancerogenesis and that oncogenes, tumor-suppressor genes, growth factors, and cytokines play crucial roles in the pathomechanism of cancer. Human papillomavirus, human immunodeficiency virus, herpes virus, and hepatitis B virus were identified as cancer-causing viruses. Several laboratory tests were developed for the detection of primary and recurrent cancers, and cancer prevention by screening methods was popularized. Sonography, computerized tomography, magnetic resonance imaging, positron emission tomography, excision of sentinel lymph nodes, and immunohistochemical techniques became routine procedures. Clinicopathologic staging and classification of tumors were standardized. Limited surgery, adjuvant and neoadjuvant chemoradiation, and the therapeutic use of monoclonal antibodies, tumor vaccines, and targeted chemotherapy became routine practice. The decline in cancer incidence and mortality demonstrated that cancer prevention and advancement in oncology are pivotal to success in the crusade against cancer. Above all, it was clearly established that the care of patients with cancer can be accomplished best in a multidisciplinary setting involving surgical oncologists, radiologists, radiation therapists, medical oncologists, surgical pathologists, and laboratory scientists. In conclusion, the 25 years from 1970 and 1995 are the high-water mark in clinical oncology, and this is the period when oncology turned from art to science. Cancer 2015;121:2480-513.

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Prognostic significance of tumor emboli in intramammary lymphatics in patients with mammary carcinoma

Cited by 105 publications

References 0 publications

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

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

Prognostic significance of peritumoral vascular invasion in breast cancer

A note from history: Landmarks in history of cancer, part 7

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