title: Grading system for lymph vessel tumor emboli: significant outcome predictor for patients with invasive ductal carcinoma of the breast who received neoadjuvant therapy.
abstract: The purpose of this study was to confirm that the grades of lymph vessel tumor emboli in biopsy specimens obtained before neoadjuvant therapy and in the surgical specimens obtained after neoadjuvant therapy according to the grading system we devised are significant histological outcome predictor for invasive ductal carcinoma (IDC) patients who received neoadjuvant therapy. The subjects of this study were the 318 consecutive IDC patients who had received neoadjuvant therapy in our institution. The lymph vessel tumor embolus grades in the biopsy specimens and in the surgical specimens were significantly associated with the increases in mean number of nodal metastases. Multivariate analyses with well-known prognostic factors and p53 expression in tumor-stromal fibroblasts clearly showed that the lymph vessel tumor embolus grade based on the biopsy specimens and based on the surgical specimens significantly increased the hazard rates for tumor recurrence and tumor-related death in all the IDC patients as a whole, in the IDC patients who did not have nodal metastasis, and in the IDC patients who had nodal metastasis, and the outcome-predictive power of the lymph vessel tumor embolus grades based on the surgical specimens was superior to that of the lymph vessel tumor embolus grades based on the biopsy specimens. The grades in the grading system for lymph vessel tumor emboli were significantly associated with nodal metastasis, and the histological grading system is an excellent system for accurately predicting the outcome of patients with IDC of the breast who have received neoadjuvant therapy.
authors.affiliation: Pathology Consultation Service, Clinical Trials and Practice Support Division, Center for Cancer Control and Information Services, National Cancer Center, Tokyo, Japan. thasebe@ncc.go.jp
authors.forename: Takahiro
authors.initials: T
authors.lastname: Hasebe
authors.forename: Nobuko
authors.initials: N
authors.lastname: Tamura
authors.forename: Motoki
authors.initials: M
authors.lastname: Iwasaki
authors.forename: Nao
authors.initials: N
authors.lastname: Okada
authors.forename: Sadako
authors.initials: S
authors.lastname: Akashi-Tanaka
authors.forename: Takashi
authors.initials: T
authors.lastname: Hojo
authors.forename: Chikako
authors.initials: C
authors.lastname: Shimizu
authors.forename: Masashi
authors.initials: M
authors.lastname: Adachi
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Fujiwara
authors.forename: Tatsuhiro
authors.initials: T
authors.lastname: Shibata
authors.forename: Yuko
authors.initials: Y
authors.lastname: Sasajima
authors.forename: Histoshi
authors.initials: H
authors.lastname: Tsuda
authors.forename: Takayuki
authors.initials: T
authors.lastname: Kinoshita
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000473:pathology*; D018270:Carcinoma, Ductal, Breast / Q000188:drug therapy / Q000401:mortality / Q000473:pathology*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008207:Lymphatic Metastasis / Q000473:pathology*; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009360:Neoplastic Cells, Circulating / Q000473:pathology*; D011379:Prognosis; D016016:Proportional Hazards Models
chemical_list: D000970:Antineoplastic Agents