title: The influences of peritumoral lymphatic invasion and vascular invasion on the survival and recurrence according to the molecular subtypes of breast cancer.
abstract: OBJECTIVE
  We aimed to compare the influences of lymphatic invasion (LI) and vascular invasion (VI) on survival and recurrence according to the molecular subtypes of breast cancer.
  
  
  METHODS
  We retrospectively analyzed data on 820 breast cancer patients and assessed overall survival (OS) and disease-free survival (DFS) according to LI and VI using the Kaplan-Meier estimator and the Cox proportional hazards model.
  
  
  RESULTS
  Both positive LI and positive VI showed inferior OS and DFS compared with negative LI and negative VI (all p < 0.001). Both positive LI and positive VI showed higher local, regional, and distant recurrence rates (p = 0.002 for regional recurrence of VI, p < 0.001 for all the others). Although LI was a significant independent predictor of OS (hazard ratio [HR] 1.927; 95% confidence interval [CI] 1.046-3.553) and DFS (HR 1.815; 95% CI 1.063-3.096), VI was not in the multivariate analyses. Regarding OS, both positive LI and positive VI showed worse survival rates in the luminal A (p = 0.016 and p = 0.024, respectively) and triple negative subtypes (both p < 0.001). Regarding DFS, LI was a significant prognosticator in the luminal A and triple negative (both p < 0.001) subtypes. VI was a significant prognosticator across all molecular subtypes, although the prognostic impact was most prominent in the luminal A subtype (p < 0.001).
  
  
  CONCLUSIONS
  Both LI and VI were significant, unfavorable prognostic factors of OS and DFS, especially in the luminal A and triple negative breast cancer subtypes. Although LI was a significant independent predictor of OS and DFS, VI was not after the multivariate analyses.
authors.affiliation: Department of Surgery, Seoul National University Boramae Medical Center, 39, Boramae-Gil, Dongjak-gu, Seoul, 156-707, Republic of Korea. kiterius@snu.ac.kr.
authors.forename: Ki-Tae
authors.identifier: http://orcid.org/0000-0001-6597-3119
authors.initials: KT
authors.lastname: Hwang
authors.affiliation: Department of Pathology, Seoul National University Boramae Medical Center, Seoul, Republic of Korea.
authors.forename: Young A
authors.initials: YA
authors.lastname: Kim
authors.affiliation: Department of Surgery, Seoul National University Boramae Medical Center, 39, Boramae-Gil, Dongjak-gu, Seoul, 156-707, Republic of Korea.
authors.forename: Jongjin
authors.initials: J
authors.lastname: Kim
authors.affiliation: Department of Radiology, Seoul National University Boramae Medical Center, Seoul, Republic of Korea.
authors.forename: A Jung
authors.initials: AJ
authors.lastname: Chu
authors.affiliation: Department of Radiation Oncology, Seoul National University Boramae Medical Center, Seoul, Republic of Korea.
authors.forename: Ji Hyun
authors.initials: JH
authors.lastname: Chang
authors.affiliation: Department of Nuclear Medicine, Seoul National University Boramae Medical Center, Seoul, Republic of Korea.
authors.forename: So Won
authors.initials: SW
authors.lastname: Oh
authors.affiliation: Department of Obstetrics and Gynecology, Seoul National University Boramae Medical Center, Seoul, Republic of Korea.
authors.forename: Kyu Ri
authors.initials: KR
authors.lastname: Hwang
authors.affiliation: Department of Surgery, Seoul National University Boramae Medical Center, 39, Boramae-Gil, Dongjak-gu, Seoul, 156-707, Republic of Korea.
authors.forename: Young Jun
authors.initials: YJ
authors.lastname: Chai
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000098:blood supply / Q000473:pathology*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000098:blood supply / Q000473:pathology*; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis
keywords: Blood vessels; Breast neoplasms; Lymphatic vessels; Recurrence; Survival