title: Lymphovascular infiltration in the tumor bed is a useful marker of biological behavior in breast cancer.
abstract: OBJECTIVE
  Tumor cells can metastasize by entering existing vessels or new vessels actively recruited into the primary tumor. Invasion of the lymphatics and blood vessels in the periphery of the tumor seems to be a prerequisite step in the metastatic process. The aim of this study was to correlate peripheral lymphatic vessel infiltration (PLI) and peripheral blood vessel infiltration (PVI) in a cohort of patients with invasive ductal carcinoma of the breast with various other prognostic parameters and outcome.
  
  
  METHODS
  The study population consisted of 236 female patients with invasive ductal breast carcinomas, who had been operated between 2011 and 2013. The registered data included age at diagnosis, histological subtype, tumor size, TNM stage, histological grade, estrogen (ER) and progesterone receptors (PR), HER-2, p53, and PLI and PVI.
  
  
  RESULTS
  Pathological examination revealed that 22.5% of the patients had PVI and 37.3% had PLI at the tumor front. PVI correlated with younger age (p<0.05), higher histologic grade (p<0.05), advanced TNM stage (p<0.05), higher T stage (p<0.05), higher N stage (p<0.05) and positive Ki67 expression (p<0.05). Similarly, PLI correlated with higher histologic grade (p<0.05), advanced TNM stage (p<0.05), higher T stage (p<0.05) and higher N stage (p<0.05). Statistical analysis did not reveal significant correlation between the presence of tumor blood and lymphatic vessels with infiltration in overall (OS) and disease-free survival (DFS).
  
  
  CONCLUSIONS
  PLI and PVI are important markers of worse clinical outcome as shown by their association with other established factors, but no association with recurrence and survival could be proven.
authors.affiliation: Second Department of Surgery, 401 General Army Hospital, Athens, Greece.
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Panagiotopoulos
authors.forename: Emmanouil
authors.initials: E
authors.lastname: Lagoudianakis
authors.forename: Apostolos
authors.initials: A
authors.lastname: Pappas
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Filis
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Salemis
authors.forename: Andreas
authors.initials: A
authors.lastname: Manouras
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Kontzoglou
authors.forename: George
authors.initials: G
authors.lastname: Zografos
mesh_terms: D000368:Aged; D014408:Biomarkers, Tumor / Q000032:analysis; D001808:Blood Vessels / Q000737:chemistry / Q000473:pathology*; D001943:Breast Neoplasms / Q000737:chemistry / Q000473:pathology* / Q000601:surgery; D018270:Carcinoma, Ductal, Breast / Q000737:chemistry / Q000473:pathology* / Q000601:surgery; D016208:Databases, Factual; D018450:Disease Progression; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008207:Lymphatic Metastasis; D042601:Lymphatic Vessels / Q000737:chemistry / Q000473:pathology*; D008408:Mastectomy; D008875:Middle Aged; D060787:Neoplasm Grading; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D016016:Proportional Hazards Models; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D047368:Tumor Burden
chemical_list: D014408:Biomarkers, Tumor