title: Blood vessel invasion and other variables as predictors of long-term survival in Japanese and British patients with primary invasive breast cancer.
abstract: This study was undertaken to investigate the associations of blood vessel invasion (BVI), lymphatic vessel invasion (LVI) or other variables and long-term survival in 173 Japanese and 184 British patients with primary invasive breast cancer, and whether they are associated with survival differences between Japanese and British patients. BVI was detected by objective methods, using both factor VIII-related antigen (F-VIII) staining and elastica van Gieson (E v G) staining. BVI was classified into three subtypes. 1) BVI e, BVI detected by E v G staining alone, 2) BVI f, BVI detected by F-VIII staining alone, 3) BVIef, BVI evaluated by combining BVIf and BVIe. LVI was also detected by objective methods, using lymphatic vessel endothelial hyaluronan receptor-1 (LYVE-1) staining alone. There was a borderline significance between the frequencies for BVIef of British patients and those of Japanese patients (8.2% vs 3.5%; P = 0.06) but not for LVI (P = 0.36). British patients had a significantly worse relapse-free survival (RFS) and overall survival (OS) than Japanese patients (P < 0.01, P < 0.01, respectively) even though their tumors were smaller and more ER-positive with a similar prevalence of lymph-node involvement. LVI was not significantly associated with RFS and OS, however, BVIef positive tumors had a significantly worse RFS and OS compared with BVIef negative patients, after statistical adjustment for the other variables (P = 0.02, P = 0.01, respectively). The present study shows that BVIef variability might contribute to the Japanese and British disparities in breast cancer outcomes.
authors.affiliation: Department of Surgery II, School of Medicine, Tokyo Women's Medical University 8-1 Kawadacho, Shinjuku-ku, Tokyo 162-8666, Japan ; Cancer Research UK, Tumor Pathology Group, Nuffield Division of Clinical Laboratory Sciences, Radcliffe Department of Medicine, University of Oxford, John Radcliffe Hospital Headington, Oxford, OX3 9DU, UK.
authors.forename: Takao
authors.initials: T
authors.lastname: Kato
authors.affiliation: Cancer Research UK, Tumor Pathology Group, Nuffield Division of Clinical Laboratory Sciences, Radcliffe Department of Medicine, University of Oxford, John Radcliffe Hospital Headington, Oxford, OX3 9DU, UK.
authors.forename: Francesco
authors.initials: F
authors.lastname: Pezzella
authors.affiliation: Cancer Research UK, Tumor Pathology Group, Nuffield Division of Clinical Laboratory Sciences, Radcliffe Department of Medicine, University of Oxford, John Radcliffe Hospital Headington, Oxford, OX3 9DU, UK.
authors.forename: Graham
authors.initials: G
authors.lastname: Steers
authors.affiliation: Cancer Research UK, Tumor Pathology Group, Nuffield Division of Clinical Laboratory Sciences, Radcliffe Department of Medicine, University of Oxford, John Radcliffe Hospital Headington, Oxford, OX3 9DU, UK.
authors.forename: Leticia
authors.initials: L
authors.lastname: Campo
authors.affiliation: Cancer Research UK, Tumor Pathology Group, Nuffield Division of Clinical Laboratory Sciences, Radcliffe Department of Medicine, University of Oxford, John Radcliffe Hospital Headington, Oxford, OX3 9DU, UK.
authors.forename: Russell D
authors.initials: RD
authors.lastname: Leek
authors.affiliation: Cancer Research UK, Tumor Pathology Group, Nuffield Division of Clinical Laboratory Sciences, Radcliffe Department of Medicine, University of Oxford, John Radcliffe Hospital Headington, Oxford, OX3 9DU, UK.
authors.forename: Helen
authors.initials: H
authors.lastname: Turley
authors.affiliation: Department of Surgery II, School of Medicine, Tokyo Women's Medical University 8-1 Kawadacho, Shinjuku-ku, Tokyo 162-8666, Japan.
authors.forename: Shingo
authors.initials: S
authors.lastname: Kameoka
authors.affiliation: Department of Surgical Pathology, School of Medicine, Tokyo Women's Medical University 8-1 Kawadacho, Shinjuku-ku, Tokyo 162-8666, Japan.
authors.forename: Toshio
authors.initials: T
authors.lastname: Nishikawa
authors.affiliation: Cancer Research UK Molecular Oncology Laboratory, Institute of Molecular Medicine, John Radcliffe Hospital Headington, Oxford, OX3 9DU, UK.
authors.forename: Adrian L
authors.initials: AL
authors.lastname: Harris
authors.affiliation: Cancer Research UK, Tumor Pathology Group, Nuffield Division of Clinical Laboratory Sciences, Radcliffe Department of Medicine, University of Oxford, John Radcliffe Hospital Headington, Oxford, OX3 9DU, UK.
authors.forename: Kevin C
authors.initials: KC
authors.lastname: Gatter
authors.affiliation: Department of Pathology, Peter MacCallum Cancer Center, University of Melbourne Australia.
authors.forename: Stephen
authors.initials: S
authors.lastname: Fox
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People; D014408:Biomarkers, Tumor / Q000378:metabolism; D001943:Breast Neoplasms / Q000378:metabolism / Q000401:mortality / Q000473:pathology*; D005169:Factor VIII / Q000378:metabolism; D005260:Female; D006801:Humans; D007564:Japan; D008207:Lymphatic Metastasis / Q000473:pathology*; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000378:metabolism / Q000401:mortality / Q000473:pathology*; D011379:Prognosis; D015996:Survival Rate; D006113:United Kingdom; D044465:White People; D055815:Young Adult
chemical_list: D014408:Biomarkers, Tumor; D005169:Factor VIII
keywords: Breast cancer; KDR/Flk-1; LYVE-1 staining; blood vessel invasion; ethnicity; lymphatic vessel invasion