Tumour cell invasion into blood vessels is significantly related to breast cancer subtypes and decreased survival.
OBJECTIVE
Vascular invasion in breast cancer is associated with increased risk of recurrence, metastases and death from disease. However, there are few studies discriminating between blood vessel invasion (BVI) and lymphatic vessel involvement (LVI).


METHODS
A population-based series of 282 breast cancers was examined (200 screen-detected and 82 interval patients) with respect to BVI and LVI in addition to basic features and molecular subtypes, using CD31 and D2-40 antibodies. This series is part of the prospective Norwegian Breast Cancer Screening Program.


RESULTS
The frequency of LVI and BVI was 25% and 15%, respectively. BVI was associated with HER2-positive and basal-like tumours, and several features of aggressive breast cancer, whereas LVI showed weaker associations. BVI was the strongest factor to predict interval cancer presentation. BVI showed significant associations with recurrence-free survival and disease-specific survival in univariate and multivariate analyses, whereas LVI was not significant.


CONCLUSIONS
Our findings indicate that BVI by tumour cells is strongly associated with aggressive tumour features including a basal-like phenotype, and BVI was an independent prognostic factor in contrast to what was found for LVI.
Department of Clinical Medicine, Section for Pathology and Centre for Cancer Biomarkers CCBIO, University of Bergen, Bergen, Norway.|Department of Pathology, Vestfold Hospital Trust, Tønsberg, Norway.
Tor A
TA
Klingen
Department of Clinical Medicine, Section for Pathology and Centre for Cancer Biomarkers CCBIO, University of Bergen, Bergen, Norway.|Department of Pathology, Vestfold Hospital Trust, Tønsberg, Norway.|Department of Pathology, Akershus University Hospital, Lørenskog, Norway.
Ying
Y
Chen
Department of Clinical Medicine, Section for Pathology and Centre for Cancer Biomarkers CCBIO, University of Bergen, Bergen, Norway.|Department of Pathology, Haukeland University Hospital, Bergen, Norway.
Ingunn M
IM
Stefansson
Department of Clinical Medicine, Section for Pathology and Centre for Cancer Biomarkers CCBIO, University of Bergen, Bergen, Norway.|Department of Pathology, Haukeland University Hospital, Bergen, Norway.
Gøril
G
Knutsvik
Department of Clinical Medicine, Section for Pathology and Centre for Cancer Biomarkers CCBIO, University of Bergen, Bergen, Norway.|Department of Pathology, Haukeland University Hospital, Bergen, Norway.
Karin
K
Collett
Department of Radiology, Vestfold Hospital Trust, Tønsberg, Norway.
Anne L
AL
Abrahamsen
Department of Radiology, Haukeland University Hospital, Bergen, Norway.
Hildegunn
H
Aase
Department of Surgery, Vestfold Hospital Trust, Tønsberg, Norway.
Hans
H
Aas
Department of Surgery, Haukeland University Hospital, Bergen, Norway.
Turid
T
Aas
Department of Clinical Medicine, Section for Pathology and Centre for Cancer Biomarkers CCBIO, University of Bergen, Bergen, Norway.|Department of Pathology, Haukeland University Hospital, Bergen, Norway.
Elisabeth
E
Wik
Department of Clinical Medicine, Section for Pathology and Centre for Cancer Biomarkers CCBIO, University of Bergen, Bergen, Norway.|Department of Pathology, Haukeland University Hospital, Bergen, Norway.
Lars A
LA
Akslen
D000368:Aged; D014408:Biomarkers, Tumor / Q000032:analysis; D001943:Breast Neoplasms / Q000401:mortality / Q000473:pathology*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology*; D010641:Phenotype; D011379:Prognosis; D016016:Proportional Hazards Models; D046888:Tissue Array Analysis
D014408:Biomarkers, Tumor
BLOOD VESSELS; BREAST CANCER; TUMOUR MARKERS