title: The relationship between lymphovascular invasion and angiogenesis, hormone receptors, cell proliferation and survival in patients with primary operable invasive ductal breast cancer.
abstract: BACKGROUND
  Several well-established tumour prognostic factors are used to guide the clinical management of patients with breast cancer. Lymphovascular invasion and angiogenesis have also been reported to have some promise as prognostic factors. The aim of the present study was to examine the prognostic value of tumour lymphovascular invasion and microvessel density compared with that of established prognostic factors in invasive ductal breast cancer.
  
  
  METHODS
  In addition to hormone receptor status and Ki-67 proliferative activity, lymphovascular invasion and microvessel density and their relationship with survival were examined in patients with invasive ductal breast cancer. Full sections and tissue microarrays (n = 384 patients) were utilised to assess these factors and were scored by appropriate methods.
  
  
  RESULTS
  On univariate analysis tumour size (P < 0.05), lymph node involvement (P < 0.01), lymphovascular invasion (P < 0.05), microvessel density (P < 0.05) and local- regional treatment (P < 0.01) were associated with poorer survival in ER negative tumours. On multivariate analysis in ER negative tumours lymph node involvement (P < 0.01) and local- regional treatment (P < 0.05) were independently associated with poorer cancer-specific survival. On univariate analysis tumour grade (P < 0.05), lymph node involvement (P < 0.001), HER-2 (P < 0.05), Ki-67 (P < 0.01) and lymphovascular invasion (P < 0.001) were associated with poorer survival in ER positive tumours. On multivariate analysis lymph node involvement (P < 0.001), Ki-67 (P < 0.001) and lymphovascular invasion (P < 0.05) were independently associated with poorer cancer-specific survival in ER positive tumours.
  
  
  CONCLUSIONS
  Lymphovascular invasion but not microvessel density was independently associated with poorer survival in patients with ER positive but not ER negative invasive ductal breast cancer.
authors.affiliation: Academic Unit of Surgery, College of Medical, Veterinary and Life of Sciences, Royal Infirmary, University of Glasgow, Glasgow G31 2ER, UK.|University Departments of Pathology, Faculty of Veterinary Medicine, Omar Almukhtar University, Al bayda, PO Box 919, Libya.
authors.forename: Zahra Ma
authors.initials: ZM
authors.lastname: Mohammed
authors.affiliation: Academic Unit of Surgery, College of Medical, Veterinary and Life of Sciences, Royal Infirmary, University of Glasgow, Glasgow G31 2ER, UK.
authors.forename: Donald C
authors.initials: DC
authors.lastname: McMillan
authors.affiliation: Unit of Experimental Therapeutics, Institute of Cancer, College of Medical, Veterinary and Life Sciences, Royal and Western Infirmary, University of Glasgow, Glasgow G11 6NT, UK.
authors.forename: Joanne
authors.initials: J
authors.lastname: Edwards
authors.affiliation: University Department of Pathology, College of Medical, Veterinary and Life of Sciences, Royal and Western Infirmaries, University of Glasgow, Glasgow G11 6NT, UK.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Mallon
authors.affiliation: Department of Surgery, Western Infirmary, Glasgow G11 6NT, UK.
authors.forename: Julie C
authors.initials: JC
authors.lastname: Doughty
authors.affiliation: University Department of Pathology, College of Medical, Veterinary and Life of Sciences, Royal and Western Infirmaries, University of Glasgow, Glasgow G11 6NT, UK.
authors.forename: Clare
authors.initials: C
authors.lastname: Orange
authors.affiliation: Unit of Experimental Therapeutics, Institute of Cancer, College of Medical, Veterinary and Life Sciences, Royal and Western Infirmary, University of Glasgow, Glasgow G11 6NT, UK.
authors.forename: James J
authors.initials: JJ
authors.lastname: Going