title: Lymphovascular invasion is an independent predictor of survival in breast cancer after neoadjuvant chemotherapy.
abstract: Various prognostic indicators have been investigated in neoadjuvant chemotherapy (NAC)-treated invasive breast cancer (BC). Our study examines if lymphovascular invasion (LVI) is an independent predictor of survival in women receiving NAC. We performed a retrospective analysis in 166 women with operable invasive BC who underwent adriamycin- and taxane-based NAC between 2000 and 2013. The presence of LVI was noted in breast excisions following NAC. Associations between progression-free and overall survival and LVI and other clinicopathologic variables were assessed. Median follow-up was 31 months (range 1.4-153 months) with a total of 56 events and 24 deaths from any cause. LVI was found in 74 of 166 patients (45 %). In univariate analysis, the presence of LVI was associated with worse progression-free survival (HR 3.37, 95 % CI 1.87-6.06, p < 0.01) and overall survival (HR 4.35, 95 % CI 1.61-11.79, p < 0.01). In multivariate models adjusting for breast cancer subtype, LVI was significantly associated with a decrease in progression-free survival (HR 3.76, 95 % CI 2.07-6.83, p < 0.01) and overall survival (HR 5.70, 95 % CI 2.08-15.64, p < 0.01). When stratified by subtype, those with hormone receptor or HER2-positive BCs with no LVI had the most favorable progression-free and overall survival. Those with both LVI and triple-negative BC had the worst progression-free and overall survival. LVI is an important prognostic marker and is associated with worse clinical outcome in breast cancer patients receiving NAC.
authors.affiliation: Department of Medicine, New York Presbyterian Hospital, Columbia University Medical Center, New York, NY, USA.
authors.forename: Ying L
authors.initials: YL
authors.lastname: Liu
authors.affiliation: Department of Radiation Oncology, New York Presbyterian Hospital, Columbia University Medical Center, New York, NY, USA.
authors.forename: Anurag
authors.initials: A
authors.lastname: Saraf
authors.affiliation: Department of Biostatistics, Columbia University School of Medicine, New York, NY, USA.
authors.forename: Shing M
authors.initials: SM
authors.lastname: Lee
authors.affiliation: Department of Biostatistics, Columbia University School of Medicine, New York, NY, USA.
authors.forename: Xiaobo
authors.initials: X
authors.lastname: Zhong
authors.affiliation: Department of Pathology and Cell Biology, New York Presbyterian Hospital, Columbia University Medical Center, New York, NY, USA.
authors.forename: Hanina
authors.initials: H
authors.lastname: Hibshoosh
authors.affiliation: Department of Medical Oncology, New York Presbyterian Hospital, Columbia University Medical Center, New York, NY, USA.
authors.forename: Kevin
authors.initials: K
authors.lastname: Kalinsky
authors.affiliation: Department of Radiation Oncology, New York Presbyterian Hospital, Columbia University Medical Center, New York, NY, USA. epc2116@cumc.columbia.edu.
authors.forename: Eileen P
authors.initials: EP
authors.lastname: Connolly
mesh_terms: D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000098:blood supply* / Q000628:therapy*; D001952:Bridged-Ring Compounds / Q000008:administration & dosage* / Q000627:therapeutic use; D017024:Chemotherapy, Adjuvant; D018572:Disease-Free Survival; D004317:Doxorubicin / Q000008:administration & dosage* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008408:Mastectomy; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis; D043823:Taxoids / Q000008:administration & dosage* / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D001952:Bridged-Ring Compounds; D043823:Taxoids; C080625:taxane; D004317:Doxorubicin
keywords: Breast cancer; Lymphovascular invasion; Neoadjuvant chemotherapy; Survival