title: Lymphangiogenesis in breast cancer is associated with non-sentinel lymph node metastases in sentinel node positive patients.
abstract: Axillary lymph node dissection (ALND) is not suggested in breast cancer patients with negative sentinel lymph node (SLN) biopsies, and SLN is the only positive node in 40-70% of the remaining cases. To distinguish a subgroup in which ALND would be omitted, we investigated the role of lymphangiogenesis in primary breast cancer as a risk factor for distal lymph node involvements in patients with positive SLNs. 86 patients were included in this study. The frequency of proliferative lymphatic endothelial cells (LECP%) was evaluated in each specimen after immunohistochemical double staining for D2-40 and Ki-67. Larger primary tumor size, increased number of positive SLNs, lymphatic vessel invasion and LECP% were significantly associated with non-SLN metastases in the univariate analysis, but only LECP% retained significance in the multivariate model. A positive correlation between LECP% and lymphatic vessel invasion was also revealed. Our study confirmed the important role of lymphangiogenesis in tumor spread, and suggested that LECP% is a promising predictor for additional axillary lymph node involvements.
authors.affiliation: Department of Oncology, The First Affiliated Hospital of Wenzhou Medical University Wenzhou 325000, Zhejiang, China.
authors.forename: Lin
authors.initials: L
authors.lastname: Lv
authors.affiliation: Department of Oncology, The First Affiliated Hospital of Wenzhou Medical University Wenzhou 325000, Zhejiang, China.
authors.forename: Rui-Min
authors.initials: RM
authors.lastname: Ma
authors.affiliation: Department of Oncology, The First Affiliated Hospital of Wenzhou Medical University Wenzhou 325000, Zhejiang, China.
authors.forename: Fan
authors.initials: F
authors.lastname: Yang
authors.affiliation: Department of Oncology, The First Affiliated Hospital of Wenzhou Medical University Wenzhou 325000, Zhejiang, China.
authors.forename: Xiao-Hua
authors.initials: XH
authors.lastname: Zhang
authors.affiliation: Department of Oncology, The First Affiliated Hospital of Wenzhou Medical University Wenzhou 325000, Zhejiang, China.
authors.forename: Du-Ping
authors.initials: DP
authors.lastname: Huang
mesh_terms: D000328:Adult; D000368:Aged; D058846:Antibodies, Monoclonal, Murine-Derived; D001943:Breast Neoplasms / Q000737:chemistry / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D007150:Immunohistochemistry / Q000379:methods; D019394:Ki-67 Antigen / Q000032:analysis; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000737:chemistry / Q000473:pathology* / Q000601:surgery; D042583:Lymphangiogenesis; D008207:Lymphatic Metastasis; D042601:Lymphatic Vessels / Q000737:chemistry / Q000473:pathology*; D008875:Middle Aged; D060787:Neoplasm Grading; D009361:Neoplasm Invasiveness; D018579:Patient Selection; D011237:Predictive Value of Tests; D021701:Sentinel Lymph Node Biopsy
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D019394:Ki-67 Antigen; C500987:monoclonal antibody D2-40
keywords: Lymphangiogenesis; breast cancer; metastasis; sentinel lymph node