J Breast Cancer.  2011 Sep;14(3):198-203.

The Role of Lymphovascular Invasion as a Prognostic Factor in Patients with Lymph Node-Positive Operable Invasive Breast Cancer

• Song YJ
• Shin SH
• Cho JS
• Park MH
• Yoon JH
• Jegal YJ

Abstract

PURPOSE
Lymphovascular invasion (LVI) is an important prognostic factor in patients with lymph node-negative patients with invasive breast cancer. However, the prognostic value of LVI it is unclear and controversial about its prognostic value in patients with lymph node-positive breast cancer patients. So, we report the an analysis of the prognostic significance of LVI in a large cohort study of patients with lymph node-positive patients with invasive breast cancer.
METHODS
We retrospectively reviewed 967 patients with invasive breast cancer that had undergone surgical treatment at our hospital, from January 2004 to December 2007. Among these thempatients, 349 patients with lymph node-positive breast cancer patients are were included in this study. We evaluated clinical and pathological data in these patients, we compared with 5-year overall survival and disease-free survival between an LVI-present group and an LVI-absent group.
RESULTS
The median follow-up was 48 months (range, 12-78 months), and the mean age of the patients was 48 years (range, 23-78 years). LVI was present in 192 patients (55%) of with tumors and was associated with age < or =40 years (p=0.009), high histologichistological grade (p=0.007), estrogen receptor status (p=0.001), tumor size > or =2 cm (p<0.001), and number of involved lymph nodes (p<0.001), but not with progesterone receptor status, HER2 status, p53 status, or tumor multiplicity. LVI was a significant independent prognostic factor for disease-free survival (p<0.001) and overall survival (p=0.006). By multivariate analysis revealed that LVI (p=0.003), number of involved lymph nodes (> or =4; p=0.005), and high histological grade (II and III; p=0.02) was were an independent significant predictors of disease-free survival and overall survival in the whole group of patients.
CONCLUSION
In this case, we demonstrated that LVI is a significant predictor of poor prognosis in patients with lymph node-positive patients with primary invasive breast cancer, LVI is a significant predictive predictor value of poor prognosis. So, LVI should be considered in the therapeutic strategy as a decision making tool in the adjuvant chemotherapy setting.

Keyword

Breast neoplasms; Lymph node metastasis; Lymphovascular invasion; Prognostic factor

MeSH Terms

Breast
Breast Neoplasms
Chemotherapy, Adjuvant
Cohort Studies
Decision Making
Disease-Free Survival
Receptors, Estrogen
Follow-Up Studies
Humans
Lymph Nodes
Multivariate Analysis
Prognosis
Receptors, Progesterone
Retrospective Studies
Estrogens
Receptors, Progesterone

Figure

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  Figure 1 Overall survival and disease-free survival of whole patients. (A) Overall survival curves are shown according to presence or absence of lymphovascular invasion (LVI). (B) Disease-free survival curves according to presence or absence of LVI are shown.

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  Figure 2 Metastasis-free survival of whole patients. Metastasis-free survival curves are shown according to presence or absence of lymphovascular invasion (LVI).

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