Is it useful to detect lymphovascular invasion in lymph node-positive patients with primary operable breast cancer?
BACKGROUND
Lymphovascular invasion (LVI) is a widely recognized prognostic factor in lymph node-negative breast cancers. However, there are only limited and controversial data about its prognostic significance in lymph node-positive patients.


METHODS
Among 931 patients operated on and monitored at the authors' institution for an invasive breast carcinoma between 1989 and 1992, all 374 lymph node-positive breast cancers entered the study (median follow-up, 126 months).


RESULTS
LVI was present in 46% of tumors and was associated with age < or = 40 years (P = .02), high histological grade (P = .01), and negative estrogen receptor status (P = .032), but not with tumor size, number of involved lymph nodes, or HER-2/neu status. LVI was an independent prognostic factor for distant metastases (P = .002). Furthermore, in HER-2/neu-negative/hormone receptor-positive (n = 287) tumors, the number of independent prognostic factors (LVI, age, histological grade, number of involved lymph nodes, and tumor size) was associated with a 5-years metastasis-free survival ranging from 100% if no factors (n = 25) to 89% +/- 2% if 1 or 2 factors (n = 186) and 67% +/- 6 if 3, 4, or 5 factors (n = 76) were present (P < .001).


CONCLUSIONS
LVI is an independent prognostic factor in lymph node-positive breast cancer and merits further prospective investigations as a decision tool in the adjuvant chemotherapy setting.
Ragage
Florence
F
Department of Pathology, Bergonié Institute, Regional Cancer Center, Bordeaux Cedex, France.
Debled
Marc
M
MacGrogan
Gaëtan
G
Brouste
Véronique
V
Desrousseaux
Marie
M
Soubeyran
Isabelle
I
de Lara
Christine Tunon
CT
Mauriac
Louis
L
de Mascarel
Isabelle
I
D000328:Adult; D001943:Breast Neoplasms / Q000098:blood supply / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D004730:Endothelium, Vascular / Q000473:pathology*; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis / Q000473:pathology; D009362:Neoplasm Metastasis; D011379:Prognosis