Lymphovascular invasion, as a prognostic marker in patients with invasive breast cancer

Abstract

Purpose: The markers of prognosis are used to predict the clinical course of disease and the outcome for patients with invasive breast cancer. Our aim is to investigate the relationship of peritumoural lymphovascular invasion (LVI) with well-known prognostic markers.

Patients and methods: Eighty-one surgically treated patients with invasive breast cancer were evaluated in this study during a mean follow-up period of 46 months (12-72). The patient's age (menopausal status), tumour size, nuclear grade, axillary lymph node involvement, and hormone receptor status were determined as markers of the prognosis. The relationship of LVI with these markers was established.

Results: Except for menopausal status (p = 0.25) a close relationship was found between the presence of LVI and studied prognostic factors. LVI was positive in 29% of T1, 54% of T2 (p = 0.028) and 100% of T3 tumours (p = 0.002). The rate of LVI (+) has increased gradually as 0%, 38% and 77% (p = 0.001) with grades 1, 2 and 3 respectively. Positive LVI has been determined in 85% (p < 0.0001) and 73% (p = 0.0004) of oestrogen and progesterone receptor negative tumours respectively. LVI was present in 14% and 73% (p < 0.0001) of patients with negative and positive axilla respectively. Metastatic cancer caused mortality in seven patients of whom 86% had more than four involved axillary nodes, and 100% LVI (+).

Conclusion: The high rate of positive LVI shows a close relationship with known markers of poor prognosis. The presence of LVI can predict a worse outcome for patients with invasive breast cancer. LVI may be used as an indicator of aggressive behaviour, metastatic ability (nodal and systemic) of the primary malignancy.