The Role of Lymphovascular Invasion as a Prognostic Factor in Patients with Lymph Node-Positive Operable Invasive Breast Cancer

Abstract

PurposeLymphovascular invasion (LVI) is an important prognostic factor in patients with lymph node-negative patients with invasive breast cancer. However, the prognostic value of LVI it is unclear and controversial about its prognostic value in patients with lymph node-positive breast cancer patients. So, we report the an analysis of the prognostic significance of LVI in a large cohort study of patients with lymph node-positive patients with invasive breast cancer.MethodsWe retrospectively reviewed 967 patients with invasive breast cancer that had undergone surgical treatment at our hospital, from January 2004 to December 2007. Among these thempatients, 349 patients with lymph node-positive breast cancer patients are were included in this study. We evaluated clinical and pathological data in these patients, we compared with 5-year overall survival and disease-free survival between an LVI-present group and an LVI-absent group.ResultsThe median follow-up was 48 months (range, 12-78 months), and the mean age of the patients was 48 years (range, 23-78 years). LVI was present in 192 patients (55%) of with tumors and was associated with age ≤40 years (p=0.009), high histologichistological grade (p=0.007), estrogen receptor status (p=0.001), tumor size ≥2 cm (p<0.001), and number of involved lymph nodes (p<0.001), but not with progesterone receptor status, HER2 status, p53 status, or tumor multiplicity. LVI was a significant independent prognostic factor for disease-free survival (p<0.001) and overall survival (p=0.006). By multivariate analysis revealed that LVI (p=0.003), number of involved lymph nodes (≥4; p=0.005), and high histological grade (II and III; p=0.02) was were an independent significant predictors of disease-free survival and overall survival in the whole group of patients.ConclusionIn this case, we demonstrated that LVI is a significant predictor of poor prognosis in patients with lymph node-positive patients with primary invasive breast cancer, LVI is a significant predictive predictor value of poor prognosis. So, LVI should be considered in the therapeutic strategy as a decision making tool in the adjuvant chemotherapy setting.

Prognostic significance of lymphatic invasion in lymph node-positive breast carcinoma: findings from a large case series with long-term follow-up using immunohistochemical endothelial marker

“…The same findings were reported in many previous studies [21][22][23][24] and from previous findings by our group. 2,7,8,15,25,26 The rate of LI in the current study was 47%, which lies in the same range as that reported in other studies: 28%, 20 46%, 13 and 55% 27 of patients with LN-positive BC in different patient cohorts. In our specimens, most of the LI lesions were detected in the peritumoral vessels (76% of LI-positive specimens).…”

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

“…Consistent with the results of a large number of studies, our study findings showed that nuclear grade played a prognostic role in node negative patients (Yuan et al, 1992;Gasparini et al, 1994;Carlmagno et al, 1996;Andrulis et al, 1998;Carol et al, 2002;Bekir et al, 2003;Polednak, 2003;Sebastian et al, 2004a;2004b;Gurleyik et al, 2007;Lee et al, 2009;Nimeus-Malmstrom et al, 2010;Song et al, 2011;Clayton et al, 2012). In the current study, the survival rate was obtained as 74.8% in grade three compared to 87.1% in grade one (Table 1), which is in contrast with the study by Ashwini et al (2008).…”

“…In line with the results of the present study, there is a global consensus about the prognostic role of Tumor size in survival of node negative patients (Carter et al, 1989;Collett et al, 1994;Fisher et al, 1997;Goldhirsch et al, 2001;Carol et al, 2002;Bekir et al, 2003;Polednak 2003;Sebastian et al, 2004;Gurleyik et al, 2007;Park et al, 2008;Lee et al, 2009;Song et al,, 2011;Clayton et al, 2012). In this study, the 12-year survival rate was equal to 87 % in less or equal to 20 mm tumor size in comparison to 71.6% in greater than 50 mm tumor size (Table 1), which is in contrast with the results of the study conducted by Sebastian et al (2004).…”

“…It has also been considered as an independent predictor in a large number of studies (Carol et al, 2002;Kim et al, 2011;Song et al, 2011). In addition, involvement of axillary lymph node is an important determinant in patient staging in TNM system.…”

Correlation of Microvessel Density with Nuclear Pleomorphism, Mitotic Count and Vascular Invasion in Breast and Prostate Cancers at Preclinical and Clinical Levels

“…Some of these factors are clinical, while some others are evaluated by pathological studies. In assessing breast cancer, in addition to the histopathological characteristics of the tumor, other factors such as tumor grade, the expression of genes related to estrogen receptors (ER) and progesterone receptors (PR), the HER-2/neu gene, the proliferation index, the TP53 gene status, and vascular invasion, are also evaluated (Moise et al, 2011;Song et al, 2011). Since studies have shown that the presence of neoplastic cells inside blood and lymphatic vessels, observed using hematoxylin and eosin (H&E) staining, increases the risk of tumor recurrence, vascular invasion is considered as a potential risk factor in patients with negative lymph node status (Rakha et al, 2011).…”